The first symptoms suggest that you have a hallux valgus ? Do not wait any longer to consult and display a preventive behaviour. But how to be sure that it’s a hallux valgus ? Who should you contact? Which examinations are required to establish the diagnosis of this condition?
Who can diagnose hallux valgus ?
The first step for an accurate diagnosis is obviously consulting a health professional. Indeed, your general practitioner can be very helpful. He/She will allow you to make your approach part of the healthcare system. He will also provide you a regular follow-up and a monitoring of the condition progression so as to identify the symptoms. In addition, when it will be necessary, he could advise you on the specialist who will better meet your needs. As a foot specialist, your podiatrist will help you decide, among the different treatments suggested after the diagnosis, which one is the most appropriate for you. For severe hallux valgus , consulting an orthopaedist will be more adapted. He/She could consider with you the surgery as the treatment of last resort.
Do not try to make a self-diagnosis. Although the Web is a large source of information, your case is unique! Only a health professional is able to establish the proper diagnosis taking into account every symptom and their history.
Examination without weight-bearing
The clinical examination is performed by a health professional. The practitioner observes and measures the in valgus deviation of the hallux and the in varus deviation of the first metatarsal bone. He’ll also examine the painful medial protrusion.
Firstly, your doctor will ask you some questions to establish the anamnesis allowing the collection of the entire history of the condition: medical history, complaints, pain, exams, treatments already administered...
He will manipulate the foot joints (especially the toes) to assess the mobility and architecture of each structure. The clinical exam also includes a range of motion test for the metatarsophalangeal joint (MTP).
Likewise, the skin is observed to identify possible cutaneous affections (of the skin) such as calluses or corns.
The practitioner will detect the presence or not of a cutaneous inflammation associated with the conflict between the foot and the shoe. He will also measure the angles of the deformities and assess their reducibility.
The podoscope examination allows to see below the feet while in support position. The aim is to distinguish the areas of excessive supports but also the deformities when the feet is weight-bearing.
This exam allows to assess the severity of the valgus position once the feet is weight-bearing but also the areas of hyper-support (insufficiency of the first shaft and weight transfer on the second one for example). It also leads to the analysis of potential compensatory behaviours (fallen arch, deformities of the rearfoot, torsion between the front and the rear of the foot, retraction of the Achilles tendon ). These few examples and a disorder of the ankle mobility can have negative consequences on the superior parts of the body like the knee or the hip.
Indeed, the interest of the static and dynamic examination is to assess the reasons for consultation considering that the foot is just the final functional element forming the lower limb. Assessing the patient as a whole is crucial.
A radiological assessment aims to confirm the pre-diagnosis of hallux valgus . Il allows to precisely analyse the angle of deviation. Thanks to this, the doctor has all the necessary information to consider with serenity which curative or corrective options could be possible.
In addition, X-Rays show the consequences of the hallux deviation on its neighbouring toes but also on the whole structure of the foot. An X-Ray of both foot from the top allows to observe the deformity angle. Several X-Ray images must be taken to determine the proper moment for surgery or the other treatment options. Moreover, an X-Ray is to be taken of both foot on the dorsal-plantar surface (from the top), weigh-bearing and in schuss, i.e. with the knees flexed at 30°.
Lastly, two further images are required: one barefoot, in profile and weight-bearing, the other to assess and observe the sesamoid bones (from the front, weight-bearing, also called the Guntz view).
According to the severity of the condition, a change of habits and a correction with a brace may be recommended. First, in case of light hallux valgus , you can wear a daily silicone protection: the bunion corrector* by EPITACT®. If, in addition to the pain and rubbing, the deviation becomes more and more pronounced, choose the flexible bunion corrector* during the day and the rigid bunion corrector* at night. These bunion protectors will realign your big toe. However, hallux valgus is a deformity that cannot disappear over time.
If these former treatments are proved to be insufficient, a more invasive option will be the only alternative: surgery. Since each case is unique, the practitioner is the only one able to choose the right alternative, provided that you agree with this invasive option.
For further information, find out the preventive and corrective measures you can preemptively adopt to relieve pain and realign your toe.
*These products are class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 07/2021