My big toe is growing sideways

Read here what to do with a sideways growing big toe, the infamous ‘ Hallux Valgus ‘!

Hallux valgus

Big toe skew

The ‘ Hallux Valgus ‘ is a very common condition of the big toe. In this condition, the big toe points more and more towards the other toes. The speed at which this happens varies from person to person. As the toe becomes more crooked, the complaint will change from purely cosmetic to annoying to very painful.

About 33% of adults experience a misalignment of the big toe, it is more common in women than in men. However, the age at which this complaint develops is decreasing.

Cause of a Hallux valgus

It is still not completely clear why and how a Hallux Valgus exactly arises. It may be the result of a congenital abnormality (position of attachment of tendon to joint) in some families this complaint is more common. But the excessive inward sinking of the foot, hypermobility and incorrect footwear also seem to be responsible for the development of this complaint.

Shoes with high heels, but also shoes with a very pointed last shape prevent the development of the hallux valgus certainly not.

Symptoms Hallux valgus

• Pain on the side of the big toe joint
• pointing ‘ out of the big toe
• Formation of a lump at the joint of the big toe ( bunion )

The Hallux Valgus is a degenerative condition, which means that without intervention the complaint will get progressively worse. The rate and end stage of the disease is unpredictable and varies from patient to patient.

The moment the big toe becomes crooked, part of the joint surface will automatically have to endure more pressure from the shoe. In response to this pressure, the body will locally produce more bone here to better cope with the pressure (action/reaction). Unfortunately, a shoe that is too narrow will give even more pressure, which triggers the lump to grow even more.

Treatment Hallux Valgus (conservative)

Treatment by a general practitioner and/or orthopedic surgeon will usually start with conservative treatment. A conservative treatment of the Hallux Valgus can ensure that the complaints decrease and that the position deviation does not worsen or worsens minimally. Conservative treatment can never ensure that the toe is fully straight again!

Conservative treatment may include:

• ‘Knobing’ of the shoe by a shoemaker (this will reduce the pressure on the bunion and thus the pain)
• Silicone toe spreader (possibly with Bunion protector ) for daytime
• Static Night Splint
• Dynamic Night Splint
• arch support with good forefoot support ( retrocapital support) and longitudinal arch support (medial support)

Treatment Hallux Valgus (operative)

If conservative treatments do not provide adequate relief from the symptoms, an orthopedic surgeon may proceed with surgery. The toe can be corrected in position and the bunion can be made smaller. However, there are a number of possible drawbacks to this:

• – Chance of functional limitation of the big toe
• – Chance of infection
• – Chance of recurrence (coming back Hallux valgus )

If you have any questions about this topic, please don’t hesitate to contact us!

References:

Verhaar, JAN & Linden, AJ van der (2005). Orthopedics . Wooden: Bohn Staffleu of Loghum