Hallux valgus is one of the pathologies which most frequently cause women to go to the orthopedist.

Sometimes the patient is worried by the deformity, sometimes by the swelling ( the so-called “bunion”), or sometimes even the fear that the situation may get worse. The frequently asked question is: “Should I have surgery even if it does not hurt yet?”.

Face the hallux valgus

It is obvious, there is not only one valid answer for all women of whichever age. In fact, it does exist a hallux valgus which the organism compensates for, but it can also develop into bigger deformities. In similar conditions, it is essential to be rational and plan a correction before the deformity forces more invasive surgical choices. On the other hand, there exist some light valgus deformities which do not foresee a danger evolution, and represent an aesthetic bother for women: this becomes obvious when they are barefoot or try to wear pointed shoes, perhaps with a 5-inch high heel! In this case, it is for the best to think over it: is it an aesthetic problem, or a functional one?

Hallux valgus, an aesthetic or functional problem

This is a very important question for both the surgeon and the patient. As a matter of fact, an orthopedic intervention is a surgical operation aimed at solving or improving the symptoms reported by the patient, in order to increase the function itself. Instead, an aesthetic intervention is aimed at modifying something which causes aesthetic and psychological discomfort to the patient. The biggest difference is the fact that an aesthetic improvement does not always correspond to a functional improvement.

So, before making a decision, one should aways have a clear diagnosis before. It is obvious that the “bunion” or the “twisted hallux” can be identified without being a doctor. A foot surgeon can tell us what kind of hallux valgus do we have, its development, and then, depending on it, he can plan the treatment procedure.

An hallux valgus can be determined by a local alteration, or instead, it can be linked to a more complex foot deformity, which is usually the flat foot. It is very important to understand this: not doing it means making a wrong choice and a serious risk of relapse.

Hallux valgus, the role of the conservative treatment.

An orthopedic insole can help to reduce symptoms and, in specific cases, to slow the deformity development. Howewer, it cannot be considered as an active adjuster of the deformity itself. The spacer role is to limit the local frictions, but it absolutely does not have any active corrective function.

Therefore, when the main aim is to correct deformities, the solution is surgical and, today, is really a minimally-invasive solution: anesthesia from knee down to foot, a 20-minutes surgery, a short admission which last for a few hours, and an immediate loading.

When should you undergo an hallux valgus surgery?

“When it hurts!” is, undoubtely, a little too simplistic answer. In fact, an important or, simply, a high-development deformity can be considered as a candidate to the corrective intervention even when the symptoms are not so striking. Therefore, in order to answer this question, is necessary to receive a diagnosis before, which can be able to clarify what kind of deformity we are talking about.

It is not hard: an x-ray of the two loaded feet (that is, when it is carried out by standing up) and a following super-specialised evaluation are enough.

So, the message is surely that when a pathological deformity, as the hallux valgus one, starts to hurt, it is necessary to receive a diagnosis and plan a treatment procedure. In fact, the simple change of shoes not only will penalise our sociability: it will postpone the problem for a short while, but it will not stop the deformity development. In those cases, one risks facing a serious deformity, with more invasive techniques. Instead, if one acts on time, it is always possible to reduce the surgical invasivity, allow an early loading, and likewise grant an early return on aesthetically satisfying shoes.