All about Hallgus Valgus and the role of physiotherapy in it

Hallgus valgus, which is also called "big toe deviation" or "bunion" in Persian, is one of the common and annoying problems in the foot area that can affect the quality of life of many people. In this disease, the big toe deviates towards the other toes and the bone is seen prominently at the base of this toe. This protrusion makes it difficult for a person to wear shoes, and pain and inflammation gradually develop in the area of the big toe.

This problem is more common in middle-aged and elderly people, but you should not have the misconception that only old age causes hallux valgus. Sometimes young people and even children may suffer from this condition for various reasons.

Hallux valgus (in English: hallux valgus) is not only an appearance problem; Rather, it can cause more serious discomfort, such as joint inflammation, swelling, and restricted motion of the big toe, making it difficult to perform daily activities such as walking, running, or even putting on shoes. Therefore, familiarity with this disease, its causes and treatment methods, especially the role of physiotherapy, is very important for all people who are facing this problem.

In this blog, in simple and fluent language, we intend to introduce you to all aspects of Hallgus Valgus; From causes and symptoms to effective and safe treatment methods, especially the key role of physiotherapy in improving and reducing the pain caused by this condition.

Causes and risk factors of hallux valgus

Hallgus valgus, or big toe deviation, occurs for several reasons and usually does not have a single cause. Knowing these factors will help you take better care of your feet and treat them faster if you notice symptoms.

The first and most important factor in having hallux valgus is genetics or family history. If someone in your family has this problem, you are also more likely to get it. Because the structure of the bones and the state of the joints are inherited and may cause the big toe to grow abnormally.
The next factor that plays a prominent role is inappropriate shoes. Long-term wearing of tight, high-heeled, or narrow-toed shoes puts a lot of pressure on the front of the foot, especially on the big toe. This pressure can eventually cause the thumb bone to deviate and create a bulge. For this reason, choosing the right shoe that respects the size and shape of the foot is a fundamental step in the prevention and treatment of this disease.
On the other hand, the natural structure of the foot is also influential in the risk of infection. People who have flat feet or joints that are too flexible are more prone to hallux valgus. This condition causes unbalanced pressure on the thumb joint and gradually changes its shape.
Also, some inflammatory diseases of the joints, such as rheumatoid arthritis, can cause swelling and inflammation in the big toe joint and accelerate the process of creating hallux valgus.
Finally, other factors such as excess weight that increases the pressure on the foot, frequent injuries or small impacts, and some neurological problems can also increase the risk of developing this condition.

Knowing these factors and timely prevention through daily care, choosing the right shoes and visiting a doctor or physiotherapist as soon as symptoms appear, can prevent the progression of the disease and maintain your quality of life.

Symptoms and stages of hallux valgus development

Hallgus valgus usually begins with a set of recognizable symptoms that change and increase in severity over time. Accurate recognition of these symptoms will help you to see a doctor or physiotherapist in the early stages and the treatment process will be faster and more effective.

One of the first signs is a bony bump on the side of the big toe, which may be just a small bump at first but gradually becomes larger and more painful. This protrusion is located in the area of the metatarsophalangeal joint of the thumb and is clearly visible.

At the same time as the bump gets bigger, pain and sensitivity may be felt in this area. The pain is usually worse when walking, wearing shoes, or activities that put pressure on the big toe. This pain can limit the movement of the thumb and decrease the balance while walking.

In addition, swelling and inflammation around the big toe joint are also common symptoms of this disease, which can make the skin red and warm. Sometimes blisters or thickened skin may be seen in this area, especially if tight shoes are worn.

Halgus valgus typically progresses through several stages:

Early stage (mild): small bump and mild pain that may be easily ignored.
Middle stage: increase in the size of the bump, more pain and limitation of thumb movement.
Advanced stage (severe): significant deviation of the big toe toward the other toes, chronic pain, inflammation, and serious difficulty wearing shoes.

It is important to carry out appropriate treatment at any stage of the disease in order to prevent further progress. In the early and middle stages, physical therapy and lifestyle changes can be very effective and reduce pain and improve foot function.

If the symptoms become severe or the movement restriction is too great, more medical interventions may be needed, which we will discuss further.

Halgus valgus detection methods

Diagnosis of hallux valgus usually begins with a visit to a doctor or physiotherapist, who can easily identify this disease based on the patient's history and clinical examination. However, to confirm the diagnosis and check the progress of the disease, various diagnostic methods are used.

The first step in diagnosis is a careful clinical examination. The doctor looks for signs of bony protrusion in the big toe area and evaluates the degree of deviation of the big toe compared to other toes. It also checks the sensitivity, pain, swelling and range of motion of the big toe. These evaluations help to determine the severity of the disease and its stage.
In addition to a physical examination, a simple photograph (radiography) of the foot is also usually performed. These images allow the doctor to accurately measure the deviation angle of the thumb bone, bony changes, and joint condition. Radiography is one of the best methods to follow the progress of the disease and plan the treatment.
Sometimes more advanced imaging such as ultrasound or MRI may be needed to rule out other problems or to investigate further. These methods can show more details of soft tissues, inflammations and possible damage to tendons and ligaments.

Finally, the doctor may determine the need to perform functional tests or more specialized evaluations based on the severity of the pain and movement limitation in order to choose the best treatment solution.

In general, accurate and timely diagnosis of hallux valgus is of great importance because treatment in the early stages can prevent the progression of the disease and prevent the occurrence of severe pain and movement problems.

Halgus valgus treatment methods and the role of physiotherapy

Hallgus valgus is a common and chronic problem, the treatment of which usually requires a multifaceted approach. The goal of treatment is to reduce pain, improve foot function, and prevent progression of thumb deviation. Fortunately, physical therapy is one of the most effective non-surgical methods for managing this disease.

In the beginning, it is very important to change your lifestyle and choose the right shoes. Using shoes with wide toes, short and soft heels can reduce the pressure on the big toe and prevent the development of deviation. Also, avoiding standing or walking for a long time can help reduce pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce inflammation and pain, but these drugs only control symptoms and are not a definitive treatment.
The main role of physiotherapy in this disease includes corrective exercises, strengthening muscles and improving balance and movement. Physiotherapists design specific exercise programs that strengthen the supporting muscles of the foot and improve the dynamics of the big toe joint. These exercises help reduce pain, improve range of motion, and prevent the deviation from worsening.
In addition to exercises, physical therapy methods such as massage therapy, ultrasound and heat therapy also help reduce inflammation and relieve pain. It is also common to use support tapes (topping) to correct the position of the thumb and reduce pressure on the joint.
In advanced cases where there is severe pain and a lot of movement restriction, the doctor may suggest cortisone injection or even surgery, but these options are the last solutions and physical therapy is recommended as the first and most important step of treatment.

Finally, timely and regular visits to the physiotherapist and adherence to exercises and treatment recommendations are the keys to success in controlling hallux valgus and maintaining quality of life.

Home exercises for hallux valgus

Home exercises are one of the most important parts of treating hallux valgus, which help reduce pain, improve movement, and prevent the progression of big toe deviation. Doing these exercises regularly under the supervision of a physiotherapist can have a significant effect on improving the condition of the feet.

Stretching the big toe This exercise helps to reduce the tension in the big toe joint. To do it, take the big toe with your hand and slowly pull it back and next to the other toes. Hold this stretch for 15 to 30 seconds and repeat 3 to 5 times.
Strengthening the muscles of the soles of the feet Spread a small towel on the floor and gather or pull it with your toes. This movement strengthens the muscles of the sole of the foot and better supports the arch of the foot and reduces the pressure on the thumb joint.
Rolling a soft ball under the footPlace a soft ball such as a tennis ball or a massage ball under the sole of the foot and gently roll the foot over the ball. This exercise helps to reduce pain and improve blood circulation in the leg area and increases tissue flexibility.
Balance exercisesStanding on one leg for 20 to 30 seconds (with support if needed) helps strengthen leg muscles and improve balance. This exercise helps reduce pressure on the thumb joint and improves walking.

Important points:

Before starting each exercise, wear comfortable and appropriate shoes or practice without shoes on a soft surface.
Avoid doing exercises when there is severe pain, and if you feel uncomfortable, stop the exercise and consult a physiotherapist.
Do the exercises daily and regularly to get the best results.
Home exercises along with specialized physiotherapy care can speed up the treatment process of hallux valgus and improve the quality of life. These solutions, especially in the early stages of the disease, play an important role in preventing the need for surgical interventions.

When is hallux valgus surgery needed?

In most cases, hallux valgus can be improved with non-surgical methods such as shoe changes, pain medications, and physical therapy. But in some special situations, surgery may be suggested as a treatment option. Accurately knowing the right time for surgery helps to prevent complications and make the patient recover faster.

One of the most important reasons for the need for surgery is severe and persistent pain that is not relieved by conservative treatments. When pain becomes severe enough to interfere with daily life, such as making it difficult to walk, stand, or put on shoes, surgery may be an option.
Another reason is the progression of the deformity of the big toe. In cases where the deviation of the thumb becomes more severe over time and causes more problems in the balance and function of the foot, surgical interventions are necessary to correct the bone and joint structure.
In addition, when non-surgical treatments such as physical therapy, anti-inflammatory drugs and lifestyle changes are not responsive and the condition of the foot worsens day by day, surgery is suggested as a more definitive solution.

The types of surgeries vary depending on the severity of the disease and the needs of the patient and can include correcting the position of the bone, freeing the surrounding tissues, or even replacing the joint. The decision about the type of surgery should be made by a specialist doctor based on detailed examinations and the individual needs of the patient.

After surgery, physiotherapy becomes especially important. Physiotherapy programs help restore normal joint movement, reduce swelling, reduce pain, and strengthen the muscles around the foot. Strict adherence to physiotherapy instructions after surgery plays a key role in quickly returning to normal life and preventing further complications.

Finally, although surgery can be a suitable solution, efforts should always be made to avoid the need for it with conservative methods and physical therapy. Going to the doctor on time and following the treatment is the best way to control hallux valgus and maintain the health of the feet.

Summary

Hallgus valgus is a common foot problem that can be painful and limiting. This disease is often caused by several factors such as genetics, use of inappropriate shoes, specific foot structure and some inflammatory diseases. Knowing these factors will help you take appropriate preventive measures and slow down the progress of the disease.

Finally, by observing prevention tips, regular physical therapy exercises and changing bad habits, you can live a more comfortable and active life and stay away from problems caused by hallux valgus.

Frequently Asked Questions About Hallgus Valgus

1. What is hallgus valgus?

Hallgus valgus or deviation of the big toe is a condition where the big toe is bent towards the other toes and a bony protrusion appears at the base of the big toe which may cause pain and swelling.

2. What is the main cause of hallux valgus?

Various factors such as genetics, wearing inappropriate shoes (especially high and pointed heels), flat feet and inflammatory joint diseases play a role in causing this condition.

3. Does hallux valgus only occur in the elderly?

No, this disease can occur at any age, even teenagers and children can get it, although it is more common in the elderly.

4. How can I prevent the development of hallux valgus?

Using the right shoes, doing strengthening and stretching exercises, weight control and seeing a physiotherapist to get the right treatment plan can help prevent it.