From the Guidelines
Hallux valgus is primarily caused by a combination of genetic, mechanical, and environmental factors, with genetics playing a significant role, and not solely by a bunion. Several factors can contribute to the development of hallux valgus, including wearing tight, narrow, or high-heeled shoes that compress the toes, foot mechanics such as flat feet (pes planus) or excessive pronation, and inflammatory conditions like rheumatoid arthritis 1. While the study by the American College of Foot and Ankle Surgeons 1 focuses on the diagnosis and treatment of heel pain, it highlights the importance of proper foot care and the potential consequences of neglecting foot health, which can indirectly contribute to the development of hallux valgus. Some key factors that can cause hallux valgus beyond a bunion include:
- Genetics: certain foot types or inherited foot structures can predispose individuals to developing hallux valgus
- Foot mechanics: conditions like flat feet or excessive pronation can alter weight distribution across the foot, contributing to hallux valgus
- Environmental factors: wearing tight, narrow, or high-heeled shoes can accelerate or worsen hallux valgus
- Inflammatory conditions: conditions like rheumatoid arthritis can lead to hallux valgus by weakening supporting structures
- Age: the natural weakening of supporting tissues in the foot over time can make older adults more susceptible to developing hallux valgus.
From the Research
Causes of Hallux Valgus
- Hallux valgus is a complex positional deformity of the first ray, and its precise biomechanical etiology remains under debate 2.
- Predisposing factors include:
- Female sex
- Age
- Constricting footwear
- Family history
- Other factors that may contribute to the development of hallux valgus include:
- Metatarsus adductus
- Equinus contracture
- Hammertoe deformity
- Pes planus 2
- The first ray plays a significant role in walking, and several factors that deteriorate its integrality, such as foot deformities, restrictive footwear, and pes planus, may be ascribed to the hallux valgus occurrence 3.
Associated Conditions
- Hallux valgus often coexists with other foot and ankle pathologies, such as:
- Metatarsus primus varus
- Hallux rigidus, a degenerative change of the first metatarsophalangeal joint (MTP-I joint) 4
- A combination of hallux valgus and hallux rigidus is not uncommon 4.
Biomechanical Factors
- The development and progress of hallux valgus is a multifactorial process, involving both intrinsic and extrinsic causes 5.
- Compensating the subtalar joint hyperpronation through foot orthoses plays a fundamental role in the hallux valgus development, preventing or at least controlling the condition's progress 3.