Hallux valgus is a common orthopedic pathology.Usually treated with surgery.Conservative approaches—exercise therapy, massage, physical therapy, medications—play an important role in the prevention and postoperative recovery of bunions.This article will discuss all the ways to treat bunions and big toe deviation.
What is hallux valgus
This is a condition in which the big toe moves to one side and bone develops in the metatarsophalangeal joint area.According to ICD 10, the pathology code for hallux valgus is M20.1.
main reasonConsider hallux valgus diseasehereditary weakness of connective tissue.Triggering factors include:
- wear tight shoes;
- Frequent walking in high heels;
- The load is too large.
Less commonly, bunion deformities occur due to developmental defects, injuries, or other conditions.
The degree and symptoms of hallux valgus
There are various classifications of bunions that differentiate between grade 3 or 4 pathology.The authors of the guideline for orthopedic surgeons use the following systematic stages of hallux valgus:
| degree | Deformation angle, in degrees | signs of deformation |
| 1 (weak) | less than 20 | Painless lump.Sometimes discomfort occurs after walking for a long time. |
| 2 (average) | 25-35 | Severe curvature makes walking difficult in high heels and shoes with narrow toes.Pain, corns, and recurring inflammation of the joints may occur. |
| 3 (heavy) | more than 35 | Severe deformity, difficulty in choosing shoes, difficulty in standing and walking, and changes in gait.Common symptoms are frequent foot pain, calluses, corns, and accompanying changes. |
Treatment of first toe hallux valgus deformity
The only way to correct severe bunions is surgical correction.Conservative techniques are mainly used in the initial stages of deformation.Bunions are treated by an orthopedic surgeon.
The main method of determining the extent of pathology is X-ray, taken with two projections through the load.In addition, the doctor may perform plantar imaging, CT, MRI, and other tests.
Surgical correction of bunions
Surgical treatment is indicated for moderate to severe hallux valgus deformity.Depending on the patient's request, minor surgery is sometimes performed to eliminate cosmetic imperfections.There are many ways to remove a lump:
- Exostosis excision;
- Osteotomy;
- Tendon transfer according to McBride et al.
Intervention is performed using the usual methods or by percutaneous correction (using a small puncture).Growths can be removed with a laser.One or more incisions are made on the side or back of the foot.The cone is cut away, sometimes causing an artificial fracture of the main phalanx or first metatarsal, and the fragments are fixed with screws.
Early stage of hallux valgusThe surgery lasts 30-40 minutes, severely deformed——up to an hour and a half.
Rehabilitation after bunion removal
Recovery after lump removal lasts approximately 2 months.The key to a complete recovery is to strictly follow your orthopedic surgeon's recommendations.If the rules of recovery are ignored, complications may occur in the long term after surgery—renewed bunion formation or lifelong limited joint mobility.
What shoes to wear after surgery
Starting the next day, you can act in Baruch's shoes.Until the swelling goes down, you shouldmove around as little as possible, most of the time the patient lies with his legs elevated.Two weeks later, walking restrictions were lifted.The Baruk boot must still be used for 1-1.5 months after bone removal.You can then wear loose-fitting sneakers or boots with a wide toe.
You need to give up heels for six months.
Can I get a massage after surgery?
Massage can be performed after the wound has completely healed.To improve circulation and lymphatic drainage, massage the entire lower body.The process begins with stroking.Then knead the soles and insteps of your feet in circular motions.Grab your ankles with both hands and move them toward your knees.In the final stages, another shot is taken.
screw foot exercise therapy
Physical therapy is a mandatory part of the bunion recovery period, starting in the third week after surgery.First, flex and extend your fingers 3 times, holding each position for 10 seconds.Repeat the exercise 3-4 times a day.All movements should be done carefully to avoid discomfort.
Starting from the second month after bunion removal, the number of repetitions is increased to 7-8 times, and the number of approaches is increased to 6-8 times a day.Discomfort is acceptable.Active actions are complemented by passive actions (with the hands).After one and a half months, you need to stand on tiptoes 5-6 times, 7-8 times a day, and maintain this posture for about 10 seconds.
Useful for walking on sloping surfaces and climbing stairs.
corrective bandage
Use an orthotic dressing after discontinuing use of the Baruk shoe.The product consists of two bandages connected by a hinge and holds the thumb in an abducted position.After 1-1.5 months, replace the bandage with a silicone pad.There should be no pressure on the legs– This interferes with blood circulation and may cause soft tissue damage.
How to get rid of bunions without surgery
In advanced bunions, it is impossible to completely cure the bunion through conservative correction.All conservative methods are used only to eliminate pain, prevent complications and curvature progression.
To ensure resultsTreatment should be started at the first sign ofHallux valgus occurs.Special exercises, massage, physiotherapy, wearing orthopedic devices and a combination of folk remedies are effective.
Foot and big toe massage
It is recommended to perform this procedure after a warm bath.
- The leg with the deformed toe is bent at the knee and placed on the thigh of the other leg, with the sole of the foot turned inward.
- Knead the soles with your fists, pressing alternately on different areas on the far side.
- Massage the bunion lump using circular motions, then extend all fingers together.
- To stimulate the flow of blood and lymph fluid, wrap your arms around your legs and move your palms from your feet to your knees.
Drugs to treat deformities
To eliminate inflammation in the bunion area, topical anti-inflammatory medications can be used.
The development of hallux valgus is accompanied by the development of arthropathy and the exacerbation of local metabolic processes.Therefore, to improve blood flow and stimulate tissue repair, medications with chondroprotective properties are needed.
There are compound ointments specifically designed for bunions.For example, a special cream contains shark oil, natural oils and extracts that have anti-inflammatory properties, relieve pain and stimulate tissue regeneration.
To reduce pain and inflammation, you can use patches and compresses with propolis, burdock and turpentine, red clay and sea salt.Apply all the composition to the protruding bone, cover it with a bandage, leave it for 1-2 hours and then wash it off.
Can bunions be corrected with exercise?
Bunion exercises strengthen ligaments and muscles and have a positive effect on the small bones.Warm up the bunion deformity with massage and then perform therapeutic gymnastics.Perform the following exercises:
- Alternate walking on your heels and provide support on the outside and inside edges of your feet.
- Walking on a suspended mat.
- Roll the bouncy ball.
- Extension and compression of the toes during sitting.
- Grasp objects (pencils, napkins, small toys).
- Draw various shapes in the air.
- Spread your feet apart and stretch the elastic on your big toe.
- Use your hands to passively flex and extend the affected joint.
These exercises are performed daily and include free stretching and stroking to relieve muscle tension.Only a constant load can influence the course of the disease.
Orthopedic instruments
Taking into account the materials, all devices for bunions are divided into three groups: soft, semi-rigid, and rigid.The soft ones can be used during the day, while the semi-hard ones can be used for up to several hours.The rigid design is designed to hold the foot in place at night.
Depending on the type of building, there are:
- finger insertion— Correcting the position of the index finger in the early stages of deformity or postoperatively.Made of soft silicone.
- Sole pad- Use soft products to increase shock absorption.Sometimes they come with a diaphragm that can eliminate bunions.
- Orthotics and bandages— Recommended for moderate and severe stages.They can be soft or semi-rigid and secure important parts of the foot.They are also used in valgus feet.
- orthopedic splint— Adjust the hallux valgus angle.Since they are not compatible with shoes, they can only be used at night.
Physical therapy for bunions
Physical therapy procedures are considered part of a comprehensive treatment and work well with massage and exercise therapy.Use the following method:
- paraffin therapy— Deeply warms muscles and ligaments, improves blood circulation and activates local metabolism.
- healing mud- Has the same effect as paraffin wax.Relieve muscle tension.
- laser treatment— Helps dilate capillaries, reduces swelling and improves protein absorption by cells.
- Ultrasound therapy- Activates metabolism and microcirculation in tissues.Stimulates collagen production.Reduce pain and swelling in the bunion area.
- shockwave therapy— Eliminates stagnant processes, stimulates blood flow, improves the delivery of oxygen and nutrients, and activates regeneration.It not only effectively acts on ligaments and muscles, but also on bone and cartilage tissue.
Prevent bunions
Prevention of bunions should begin as early as possible.Pay special attention to the health of your children’s feetA relative in his family suffers from hallux valgus and has a lump on his thumb.Bunions develop in flat feet, so children and adults with this pathology need regular exercises to strengthen the ligamentous muscular apparatus.
It's important to choose the right shoes - loose-fitting, with stable soles and made of natural materials.You should ditch the heels.Wearing arch supports is helpful.Orthopedic insoles are recommended if indicated.Regular but not excessive physical activity is beneficial.
You should get rid of excess weight to reduce dead load.