When many people opt for open-toe shoes in the summer, bunions (hallux valgus) are a common concern. This condition causes the big toe to angle towards the smaller toes. If the bunion isn’t painful, surgery may not be required. However, if pain is present, early treatment is advised. Without intervention, the deformity can worsen over time.
Often referred to as “high heel disease,” hallux valgus frequently develops from prolonged use of narrow, high-heeled shoes. The protruding area on the inner side of the foot rubs against the shoe, causing pain and inflammation. Genetic factors, such as flat feet or a family history of the condition, also play a significant role.
Early treatment for hallux valgus is crucial because the deformity of the big toe will worsen if left untreated. Surgery may be necessary to correct the condition entirely. The abnormal protrusion of the big toe can lead to pain in the foot, which may affect walking and result in knee or lower back pain.
Dr. Yoon Young Sik, director of the Foot and Ankle Center at Barun Health’s specialized orthopedic hospital, appointed by the South Korean Ministry of Health and Welfare, emphasized, “People often dismiss foot pain as a minor issue caused by their shoes. They usually seek medical attention only after worsening the condition, even though the feet are vital to overall well-being.”
Last year, 54,665 patients sought treatment for hallux valgus, 81% of whom were women. Recently, there has been a rise in cases among men, partly due to the increasing use of narrow shoes and height-increasing insoles.
Yoon noted, “In the summer, when feet are more exposed, women seek corrective treatment for foot deformities. However, if there is no pain, surgery may not be necessary, even if a deformity is present.”
The main symptoms of hallux valgus include difficulty wearing narrow shoes and pain in the big toe joint. As the condition worsens, walking can become increasingly uncomfortable. If left untreated, hallux valgus may also lead to secondary problems, such as damage to the ankle ligaments, arthritis in the knees, and issues with lower back discs.
A brace between the big and second toes or corrective insoles can help with mild symptoms. However, if the pain is severe, affects walking, or complications arise, surgery may be recommended. Proper management is crucial, as the weight distributed on the big toe can lead to further complications if not addressed.
The surgical approach becomes more complex if the hallux valgus angle exceeds 40 degrees. Professor Choi Jun Young from the Orthopedic Department at Inje University Ilsan Paik Hospital emphasized, “Using a brace alone won’t stop the deformation or correct it to its original state. Regular monitoring of the foot’s condition is important.”
For severe cases requiring surgery, choosing a method that minimizes bone and ligament damage is essential. Hallux valgus surgery is intricate because it involves important nerves, ligaments, and blood vessels around the deformed big toe, making it crucial to avoid damage to surrounding tissues.
Traditionally, correcting deformed bones involved making an incision on the inner side of the big toe, which often caused significant psychological distress for patients. However, recent advancements have introduced a minimally invasive technique, Minimally Invasive Correction of Hallux Valgus (MICA). This method uses four to five small incisions, each less than 4-5 mm, reducing post-surgical pain and scarring.
Depending on the deformity, Hallux valgus is classified into early, middle, and advanced stages. Minimally invasive surgery is effective for patients in the early and middle stages. If the deformity is not excessively severe, surgery may still be possible for those in the middle stage or beyond.
The surgery typically lasts about an hour, and recovery is relatively quick, allowing patients to be discharged within 2 to 3 days. Patients can walk in special post-operative shoes after wearing a partial cast for 1 to 2 weeks. Within approximately 2 months, they can resume normal walking in regular athletic shoes.
Choi advised, “If your job requires frequent wearing of narrow or high-heeled shoes, it’s important to check your feet regularly. Shoes made of fabric are preferable to leather, and athletic shoes with low heels are best for preventing hallux valgus.”
He added, “Stretching and foot baths do not correct or prevent hallux valgus. However, they can help alleviate bursitis, a major source of pain associated with the condition.”
Yoon emphasized, “The big toe is crucial for walking. For a successful hallux valgus surgery with fewer complications, it’s essential to receive an accurate diagnosis from a foot and ankle medicine specialist and undergo the appropriate surgical procedure.”