Home

www.chiropractieonline.nl

Hallux Valgus

About

Hallux valgus is a slow-developing condition that occurs when the big toe, over many years, bends out of shape and then forms a large bump on the foot called a bunion. Look at your toes: If your big toe bends toward the other toes on the same foot, you've probably got the condition.

People with hallux valgus usually report that their big toe hurts when they put weight on it -- when walking, for example. But if they have a bunion, it can hurt even when they don't place pressure on their foot, and they usually describe this pain as a "numbing" or "burning" sensation.

The name hallux valgus combines hallux, which is another term for the big toe, and valgus, which refers to that big toe's deviation when you have the condition. Despite the name, however, the big toe isn't the only structure affected. Three bones actually shift, two that make up the big toe and one in the forefoot that the toe attaches to, the first metatarsal.

The metatarsal and big toe are connected by a joint that you feel as a bump on the inside of your foot, just below the toe. Hallux valgus often develops when there's damage to this joint, known as the metatarsophalangeal joint. If you have a bunion, it's the joint it grows on. The usual cause of damage is some sort of chronic abuse, but other factors can also be responsible, such as a broken toe that doesn't heal properly.

The condition usually becomes apparent during middle age and is most common in women who wear a lot of high-heeled or pointed shoes. Restrictive footwear of this nature can aggravate the foot and cause the condition because of the pressure it places on the big toe.

People who over-pronate, who have a genetic-based predisposition to roll their feet inward too much every time they step, are also susceptible. When they do this, it can put pressure on the big toe and first metatarsal. Other genetic-based causes of hallux valgus include poor foot structures and inflammatory arthritis. Inflammatory arthritis can lead to the condition because it sometimes causes severe degeneratation of the metatarsophalangeal joint and leads to abnormalities in surrounding bones.

If you have hallux valgus, your healthcare practitioner can examine your foot to determine which factors contributed to your condition. He or she may then use a number of techniques and modalities to decrease pain and improve your foot's function.

Anatomy

Each time you take a step, your foot absorbs an impact even greater than your body weight. With that in mind, consider that the average person takes between 8,000 and 10,000 steps daily. Over time, all that pressure and work can cause small problems in the feet to become large problems, and that's what happens with hallux valgus.

Hallux valgus refers to an irregular shifting of the big toe and a bone in the forefoot called the first metatarsal. If you reach down and run your hand over your foot you can feel the first metatarsal, as well as the four other metatarsals that attach to the other toes. The first metatarsal attaches to your big toe at the metatarsophalangeal joint, and that is where hallux valgus occurs.

If you have the condition, your first metatarsal will have shifted toward the midline of your body and your big toe will have shifted in the opposite direction, toward the other toes on the same foot. When this happens, the metatarsophalangeal joint may rub against your shoe and become inflamed.

This inflammation can lead to the development of a large growth called a bunion. Bunions develop when there's a hardening of a cushioning structure in the foot called a bursa. Repeated irritation causes that bursa to toughen up. Bunions don't always occur when people have hallux valgus, but when they do, they're most common in women who wear high-heeled or pointed toe-squishing shoes.

Restrictive footwear can cause hallux valgus, as can a number of other factors that contribute to long-term strain on the feet. As mentioned in the About section, predisposition to hallux valgus can have genetically-based sources such as poor foot structures, over-pronation and inflammatory arthritis.

Over-pronation is also one of the main causes of pain associated with the condition. When people over-pronate, they rotate their feet too far inward when they walk, which puts added strain on the metatarsophalangeal joint.

If you have pain related to hallux valgus or an associated bunion, your chiropractor can help alleviate it and address underlying problems that are contributing to problems with your feet. With the amount of time you spend on your feet each day, you'll be thankful.

Chiropractic Care

Take off those tight shoes and slip into something a little wider in the toes. If you have hallux valgus, this could be your chiropractor's first recommendation. Once you take such steps, he or she can care for your condition by selecting from a variety of tools and techniques, depending on the severity of your condition and its course of progression.

You should note, however, that conservative chiropractic care can't straighten the bones of the big toe and metatarsal; this requires surgery. But your chiropractor can help reduce and possibly eliminate painful symptoms, and if you require surgery, he or she will be able to make an appropriate referral and outline the risks.

When you first visit your chiropractor with hallux valgus, he or she may need to perform an adjustment to the joint between the big toe and the first metarsal, called the metatarsophalangeal joint. If your foot problems are affecting other parts of your body, your chiropractor may also perform an adjustment to these areas. An adjustment is a quick, strategic thrust with either the hands or a special tool called an activator that can help restore joint function and the health of surrounding tissues. Your chiropractor can perform this on dysfunctional joints in the foot, knee, hip and low back. When you walk, these joints must work together to allow you to move efficiently. When movement of any joint is altered, it can affect other joints that work with it.

Think of your body as a long chain connected by links. If one of the links is broken, the other links can't provide the same stability they did before. Your chiropractor can restore the links by applying a force or thrust to dysfunctional joints, shifting them back to their original placement. This restores their motion, relaxes the tight surrounding muscles, increases blood flow and decreases inflammation.

Your chiropractor may also need to stabilize, support and cushion your big toe to prevent the condition from worsening. To do this, he or she may tape the toe back into its proper position and, if you have a bunion, place padding over the metatarsophalangeal joint to prevent the area from rubbing against your shoe and getting inflamed.

If you have underlying foot problems, your chiropractor may also need to address them. Problems such as over-pronation, which occurs when the feet roll too far outward during walking, can predispose people to hallux valgus. If you over-pronate, your chiropractor may prescribe custom functional orthotics, which are shoe inserts that help to offset structural problems and normalize foot motions.

Orthotics are an effective tool to stop hallux valgus from worsening, and one study has shown that soft tissue therapies combined with orthotics can also help reduce pain and discomfort associated with the condition. The therapies help release the tension that builds up in muscles around the foot. One of the most common is trigger point therapy, which uses applied pressure to separate contracted muscle fibers. By applying pressure with his or her thumb for about 10 seconds and then releasing it, your chiropractor can promote an influx of fresh circulation that washes out chemical irritants and brings oxygen and nutrients to damaged tissue.

To further promote muscle health, your chiropractor may use physiotherapeutic modalities such as ultrasound, which can also decrease pain and promote healing. Ultrasound refers to any sound wave that has a frequency above the range the human ear can perceive. To produce these waves, chiropractors use a machine that channels electricity through a crystal located at the end of an applicator. The crystal vibrates in response to electricity, and the machine allows users to alter the electrical current to affect the waves' frequency. Depending on the frequency, this can increase blood flow, reduce muscle spasm, lessen nerve root irritation and break down scar tissue.

If the symptoms of hallux valgus flare up, your chiropractor may also recommend a cold application, such as an icepack, for your foot. By using a cold application, you can constrict blood vessels to reduce the release of inflammatory fluid and numb pain receptors to reduce pain.

Finally, if your condition is severe, your chiropractor may refer you to a medical specialist for surgery. Surgical correction can straighten the big toe and metatarsal, as well as pare down a bunion. If you require surgery, your chiropractor can help in the post-operative phase of your rehabilitation by performing joint adjustments and physiotherapeutic modalities, as well as by recommending exercises to get you back on your feet.

Top

Newsletter Sign Up

3D Spine Simulator


Launch 3D Spine Simulator

Contact

Chiropractie Online
Ceintuurbaan 424hs
Amsterdam, North Holland 1074EB
Get Directions

Community Content