One of the most common foot complaints is pain due to hallux valgus, more commonly known as bunions.
Though bunions have been the punch line of a few jokes, in reality this deformity of the forefoot causes extreme pain. DCs may well be able to help patients with this condition, particularly if it is caught early. Advanced cases often require surgery, which is not always successful.
What is it?
Physiopedia.com gives a good description of hallux valgus:
“In this foot deformity, the medial eminence becomes prominent as the distal end of the first metatarsal drift medially and the proximal phalanx deviates laterally. The first MTP becomes subluxed, what leads to a lateral deviation of the hallux, medial displacement of the distal end of the first metatarsal and bony enlargement of the first metatarsal head. With progression, the pull of the adductor hallucis tendon and the intermetatarsal ligament cause the sesmoids to erode the cristae underneath the first metatarsal cuasing the sesmoids to sublux laterally.” 1
Preventative measures and treatment options
Patients who suffer the pain of hallux valgus and seek traditional medical treatment early are usually treated conservatively, while those in a more advanced stage often face surgical intervention.2 Some preventative or early-stage steps include:
- not wearing high-heels or shoes with tight toe boxes
- weight oss, or maintenance of a healthy weight
- proper foot pronation while walking
Night splints, taping, and other biomechanical interventions are also useful, however, such treatments may need to be on-going for the patient to enjoy continued benefit. Physical therapy, including exercise, may also provide some pain relief over time.2
How chiropractic can help
Adjusting the metatarsal joints can be helpful, either using an instrument such as a hand-held neuromechanical adjusting tool or via a manual technique. Although more research is necessary for concrete results, preliminary studies seem to indicate that manual and manipulative therapy can be more effective than current standard treatments.3
DCs can also use instruments to treat adhesions in the plantar fascia with soft tissue mobilization, which can improve motion and bring about pain relief
1 Erika VH, Lowe R, Svoboda B, Zumo K. “Hallux Valgus.” Physio-Pedia.com. http://www.physio-pedia.com/Hallux_Valgus. Accessed February 2015.
2 Klugarova J, et al. The effectiveness of surgery for adults with hallux valgus deformity: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports. 2014:12(7).
3 du Plessis M, et al. Manual and manipulative therapy compared to night splint for symptomatic hallux abducto valgus: An exploratory randomised clinical trial. The Foot Journal. 2011:21(2);71–78.