Hallux valgus is definitely a very common pathology, resulting from the varus deviation of the first metatarsal.

The role of footwear in the hallux valgus pathology

The cause of this pathology is still unknown. Much is ascribed to wearing high-heeled shoes, even though this correlation has never been proven scientifically. In fact, the only fault of high-heeled shoes is the attention they draw on the already existing issue, by making it more symptomatic. By wearing tighter and pointed high-heeled shoes, the friction between shoe and skin might increase, therefore it can intensify the pain and force the patient to remove the shoes in order to have some relief.

As a result, the hallux valgus leads to a “broadening” of the forefoot with some difficulties in wearing normal shoes. The fifth toe bunionette is often associated with hallux valgus, and it contributes to the increase of the forefoot size.

Which shoes to wear with hallux valgus pathology

First phases of the pathology


During the first phases of the pathology, the hallux does not seem very diverted, and we still have a physiological behaviour from toes. In this phase, pain can derive from metatarsalgia (that is, pain in the metatarsal region) rather than from the hallux itself.

The patient can wear any pair of shoes she can put up with. During this phase, an orthopedic insole may be recommended.

However, it is important to know that the insole neither will slow down nor correct deformities, that sometimes it may represent an obstruction inside the shoes, and therefore it can be experienced as a further source of trouble and pain for the patient, rather than a help.

Advanced phases of the hallux valgus pathology


During the most advanced phases, the patient herself reports the impossibility of wearing aesthetically gratifying shoes, since she has to make do with so-called “comfy” shoes, with some difficulties as well.

The main problem of this case derives both from metatarsalgia and directly from the hallux and the bursitis which it is often linked to and whose contact with shoes generates a pain perception which hinders the ambulation process.

In this case, the varus deviation is also connected with a deformity of toes which become “mallet”, and are responsible for a further friction against the shoe, resulting in possible ulcers and blisters on the back of the toes themselves.

In short, what can we do about the hallux valgus pathology?

To sum up, we can say that there is no footwear responsible for hallux valgus. Also, there is no corrective footwear, let alone able to take away and delay the appearance of this issue once revealed. The perfect shoe is the shoe we like until it becomes a problem if worn. When the forefoot deformity does not allow to wear certain shoes anymore, the footwear we need to choose is the comfy one!

The help from current surgery

Nowadays, thanks to reliable and reproducible surgical techniques, we can talk of successfully correcting some important deformities as well, by giving our patients not only the chance to walking again painlessly, but also to do it again with the footwear they prefer!

For more information about hallux valgus, please have a look at a thorough examination.

Regarding the Louboutin shoes picture, we thank andersphoto / Shutterstock.com