Why does a bunion grow near the big toe and how to deal with it. Treatment methods for bunions and bumps on the feet

Slender, beautiful legs in high-heeled shoes, of course, look very impressive, but for many women, such shoes threaten the appearance of deformation of the joints on the big toes. Such bones lead to a change in position thumb and protrusion of the joint outward.

If you go to an orthopedist with bunions on your big toes, he will diagnose you with “valgus deformity of the foot.” The development of such a pathology is typical for women, since due to the characteristics of their body, the ligaments of the feet of the fair half of humanity are weak and this affects when wearing shoes with heels.

In this article we will look at all aspects of treating a bunion on the big toe at home using various means.

Causes

This problem affects mainly the fairer sex, while in men the ligaments are much stronger, and such deformation of the foot is possible only as a result of injury. The essence of this problem is the protrusion of the head of the joint (bone) of the big toe. In this case, the big toe tilts to the side, and often even overlaps the adjacent toe.

Reasons why hallux valgus occurs and a bone appears on the foot:

genetic predisposition;
osteoporosis;
endocrine disorders (obesity).

But to deform the thumb you need provoking factors:

incorrectly selected shoes, i.e. narrow, not the right size;
rheumatoid arthritis can also trigger a genetic predisposition;
foot injuries that compromise the integrity ligamentous apparatus;
professional stress;
excess weight.

Etiology of this disease orthopedists began to study it relatively recently - at the beginning of the 20th century. And they came to the conclusion that the bone on the big toe is more likely to become inflamed in those who suffer from diseases endocrine system, metabolic disorders, leads an unhealthy lifestyle, is overweight, and also lives in regions that are unfavorable from an environmental point of view.

Another reason for the appearance of bones is a systematic lack of vitamins A, C and E in the body. Together, they ensure the normal functioning of the joints, and their deficiency weakens the joints and ligaments.

Why does the bone on the foot near the big toe hurt?

Normal deviation of the thumb to the first metatarsal is 10 degrees. As the bone grows, it increases in size and requires treatment. Depending on the deviation, there are several degrees:

1st: the thumb moves slightly - less than 20 degrees. There is no discomfort, redness, or pain, and the inconvenience is purely aesthetic.
2nd: finger offset– 20-30 degrees. Symptoms: mild discomfort, slight pain after a long walk.
3rd: displacement – up to 30-50 degrees. Symptoms: soreness of the bone (redness, swelling), limited mobility of the joint.
4th: displacement - over 50 degrees. Symptoms: severe pain, callus formation, discomfort when moving, difficulty choosing shoes.

With hallux valgus, pain occurs due to excess pressure in the head of the first metatarsal bone. The pain intensifies when the foot is in shoes.

Symptoms

The first warning signs of the appearance of a bunion near the big toe include the following symptoms:

redness in the thumb area;
swelling, fatigue of the legs;
aching pain on the foot near the big toe throughout the day;
acute pain in the foot after sleep when trying to stand up;
calluses.

If you see the first signs of bunion formation, seek professional help immediately before it is too late to use traditional treatment.

How to get rid of a bunion at home?

No matter how amateurs claim traditional medicine that the treatment of a bunion on the big toe is possible only with baths with the addition of herbs and salts - you cannot get rid of it this way. This will only provide temporary pain relief.

Treating a bunion at home without surgery is a fixative that will prevent the disease from progressing. It is effective in the early stages of the disease, when deformation has already begun, but constant pain are not yet accompanying the patient. The fixative allows you to pause the process, slowing down the progress of the disease. It is also used as a temporary measure if it makes sense: for example, while the brace is worn, the patient will lose excess weight or undergo a course of treatment to strengthen bones, that is, eliminate the cause of the deformation. The fixator is also necessary during postoperative rehabilitation, when treatment depends on maintaining a state of rest.

In addition, treatment of bunions near the big toe at home is carried out using orthopedic insoles and intertoe plates. Insoles ensure correct and uniform distribution of the load on the feet. This, moreover, relieves stress from the spine and legs. Insoles cannot be bought just like that; they are selected specifically for the foot, after the doctor’s recommendations. These insoles fit into any type of shoe, they are thin and do not cause discomfort.

Massage

Foot massage is very useful; it is needed not only for restoring blood flow and activating blood flow. useful substances, it also helps relieve tension from muscles, ligaments, tendons, helps to relax and cope with stress.

Moreover, on the foot there are all points associated with each organ and simultaneous acupressure feet will improve your overall health. It is ideal to massage for 20 minutes every day for 10 days, then take a 3-week break and repeat the course.

Shoes

You should only choose the right shoes - round toes (for more room for your toes), heels no longer than 4 cm, thick soles, material - genuine leather, instep support. Complete with orthopedic insoles - an ideal option.

Gymnastics

As for gymnastics, performing simple and easy-to-do exercises daily gradually strengthens the foot and reduces the influence of factors leading to the development of inflammation:

pick up small objects scattered on the floor with your toes;
take a pencil or pen with your toes and draw numbers or letters on paper;
You can also place a crumpled fabric on the floor and only try to straighten it with your toes;
walking on tiptoes, barefoot.

Diet

Dishes that provoke inflammatory processes in the joints are excluded from the diet. Namely - fried and smoked, sweets, spices and legumes, fatty broths. Foods rich in vitamins E, A, C are added to the diet to increase the stability of the ligamentous apparatus.

Operation

If the metatarsal bone has already shifted quite significantly and therapeutic methods cannot return it to its normal position, surgical intervention is recommended. The type of operation is chosen by the attending physician. This takes into account accompanying illnesses the patient, the degree of deviation of the finger from the normal position, the presence of secondary deformities of the foot and fingers.

Surgical intervention to cut off the bone to correct deformity is called osteotomy and is performed using both open and closed approaches. Closed osteotomy does not involve incisions and is performed through small punctures, which is more aesthetically correct. This is a low-traumatic method of correction, which does not involve radical cutting of part of the bone, which significantly reduces pain. surgical intervention and, as a result, makes it possible to reduce the amount of pain medication.

After a closed osteotomy, the patient is usually discharged the next day and continues recovery at home.

How to treat a bunion on the big toe: folk remedies

Traditional medicine offers many recipes for eliminating bunions on the feet. Delving into the essence of this pathology, one can understand that traditional methods cannot correct bone deformation and can only be used in the initial stages of the disease to relieve inflammation, eliminate pain and normalize blood circulation in the area of the phalanges of the thumb.

When a bone in your foot hurts, you don’t always have the strength to wait for the traditional medicine to infuse, or to prepare it. Therefore, you can use banal pharmacy iodine, which is usually present in every home medicine cabinet. They simply draw a mesh on the bone.
Lubricate the bones on your feet 4-6 times a day elderberry tincture with vodka. It is done simply - in May-early June, collect black or red elderberries, compact them into a 0.5 liter jar and fill them with vodka. Leave for 3 weeks, shaking the jar daily.
One hundred grams dandelion flowers you need to grind them and let them dry a little, then iodine is added to the medicinal raw material in such an amount that it covers the flowers. This product should be used after it has been infused for four days. The feet are thoroughly steamed, wiped dry, and then the resulting composition for the treatment of bunions is applied to it in the form of a mesh. This procedure is recommended to be carried out daily at night for two weeks.
Compress of honey and cabbage leaves. This compress is best applied at night. Before going to bed, steam your feet in a warm bath, apply honey to the bone and cabbage leaf(the leaf needs to be slightly kneaded for the juice to come out), secure with a bandage. In the morning, wash off the remaining honey warm water. The procedures are carried out over a month.
When starting a course of treatment for hallux valgus, you should regularly do salt foot baths. To prepare the bath you will need to dissolve in hot water ordinary food table salt. After this, let the water cool slightly so that you can immerse your feet in it, and steam them for 10-15 minutes. Such baths help dissolve salt deposits that form on the foot. The course of taking baths lasts two weeks, after which you need to take a week break and repeat the course again.
Mix 1 raw chicken yolk and half a teaspoon of salt, put it on a piece of bandage and apply it to the bump overnight. Do this until the pain disappears and the bone shrinks.

In the folk treatment of bunions, not only external methods are used. To remove accumulated uric acid from the body, which often turns into growths on the bones, you can take a decoction of madder. For a glass of water you will need a teaspoon of crushed madder root. This mixture is boiled in a water bath for about ten minutes. Drink ½ cup strained and cooled before meals in the morning and evening.

Prevention

To prevent a bunion from bothering you, follow these simple recommendations:

Choose shoes according to your foot size;
Shoes should be comfortable, moderately spacious, with a comfortable small heel;
To prevent leg fatigue, you should not spend a lot of time in high-heeled shoes;
Walk barefoot more often;
Before going to bed, massage your feet, pamper them with salt baths;
When playing sports (running, race walking), buy shoes designed for these sports.

Even if you have already gotten rid of a bunion on your big toe, it is better not to wear shoes with narrow heels higher than 4 cm, and also to put orthopedic insoles in any shoes. The latter effectively unload the anterior arch and transfer the load to the lateral row of muscles, thereby restoring the normal position of the leg.

A growing “bump” on the leg causes a lot of inconvenience and anxiety. Unpleasant cosmetic defect when a bone grows on the foot near the big toe, it causes difficulty in choosing shoes, periodic pain in the deformed joint, and rubbing on the toes. The causes of bone growth include flat feet, joint pathologies, weakness connective tissue. Protrusion of the first metatarsophalangeal joint refers to irreversible changes in which conservative treatment only pauses progression. The foot can be restored to its former beauty through surgical excision of the bone tissue.

Anatomical features of the foot

A quarter of all the bones of the human skeleton are concentrated in the feet. Distal section lower limbs consists of fifty-two bones that form the tarsus, metatarsus and phalanges of the fingers. The foot is a movable shock-absorbing structure, thanks to numerous joints and ligaments.

The bone structure forms two longitudinal and one transverse arches, which have the ability to bend and return to their original state. The elastic structure gives the foot a spring function, protecting the spine and joints of the lower extremities from shocks while walking. Weakening and bending of the arches leads to the development of flat feet, which can lead to deformation changes in the joints of the foot.

Hallux valgus (Hallux valgus) is a process where the bone on the foot grows near the big toe. Bone overgrowth is a complication of the descent of the transverse arch, which is located in the front of the foot in the area of the five metatarsal bones.

The thumb is the largest, it is located separately from the other fingers, with a slight displacement to the side. Normally, the finger is positioned straight, its phalanges are in the same plane. As a result of transverse flatfoot, the toe deviates outward, and the head of the first metatarsal bone forms a small tubercle, which begins to increase over time. The consequence of hallux valgus is destructive changes in the joint, which lead to cartilage degeneration and bone tissue proliferation.

Why does the bone grow

Hallux valgus deformity most often affects the female population of the planet. This fact is associated with the weakness of the ligamentous apparatus, which, under the influence of provoking factors, leads to the development of transverse flatfoot. Hormonal changes in the body, the effect of relaxin during pregnancy, addiction to high heels are the main causes of biomechanical disorders anterior section feet.

Genetic predisposition, during the growth of a bone on the foot near the big toe, can be observed in different generations. Pathology is provoked by features anatomical structure, when the metatarsal phalanx has an elongated shape. Increased body weight creates heavy load on the foot, causing arches to sag.

The bone protrusion is constantly injured when the surface of the bone rubs against shoes, which leads to the development of bursitis. The inflammatory process occurs as a result of tissue damage, leading to degenerative changes that cause deformation at the level of the medial metatarsophalangeal joint.

Metabolic disorders are another reason for bone growth. Osteoporosis with a decrease in bone density leads to deformities not only of the foot, but also of the spine.

Increased synthesis uric acid causes gout, the main symptom of which is the deposition of urate in the form of crystalline powder in the cavity of the joint capsule. This pathology It has distinctive feature– periodically appearing pain attacks in an enlarged joint.

Clinical picture

The pathological condition with the growth of a bone on the leg develops gradually. At the initial stage, the appearing “bump” looks like a slight increase, which does not deliver discomfort except appearance. The only thing that accompanies hallux valgus at the first stage is flattening of the forefoot, indicating progressive flatfoot in the transverse projection.

After some time, the “bump” increases, and the thumb deviates towards the second finger. Changes occur against the background of pain and fatigue in the legs after a long walk.

If therapeutic measures are not taken, the deformation becomes significant:

the bone grows to large sizes;
the pain syndrome becomes permanent;
the thumb “lies” on the neighboring one;
the remaining fingers are deformed, acquiring a hammer-like shape.

There are four stages of hallux valgus:

The angle between the first and second metatarsal bones is no more than 20°; the bone at this stage is slightly noticeable and is perceived as a minor cosmetic defect.
The thumb deviates up to 30°, the protrusion of the head of the bone is significant. Anatomical modification leads to pain after prolonged physical activity.
The angle increases to 40°, destructive changes occur in the deformed joint when the bone on the big toe grows due to the active growth of bone tissue.
The fourth stage is characterized by a finger deviation of 50°. The pathology is associated with chronic pain, inflammatory and degenerative processes.

Pronounced bone growth is subject to regular rubbing in shoes, not only in the area of the protruding bone, but also between the touching toes.

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Frequent injury can cause inflammatory process() with the development of characteristic symptoms:

the pain intensifies and is constant, regardless of physical activity;
the bone swells;
the area of the metatarsophalangeal joint turns red and becomes hot to the touch;
movement of the foot with the participation of the front toe is difficult.

A similar clinical picture develops with. The main difference is the nature of the pain, which is comparable to impulses electric current, which pierces the joint. A gout attack occurs mainly at night and lasts from a couple of hours to several days.

Diagnostics

It is not difficult to diagnose Hallux valgus; upon visual examination, the external changes big toe, and the entire foot as a whole. It is important to accurately determine the cause of deformation to stop pathological process and getting rid of an unpleasant symptom.

Orthopedists carry out preliminary diagnostics using a plantograph. As a result of examining foot prints, the doctor preliminarily determines the stage and type of flat feet. A more detailed study is carried out using an x-ray.

Presence of signs of inflammation will require evaluation general condition and pathogen identification. Using the results general analysis blood and urine, inflammation, metabolic disorders are detected: increased uric acid content, indicating gout. To determine the microorganism as the cause of inflammation, a sample is taken synovial fluid during diagnostic puncture deformed joint.

Based on the above measures, a diagnosis is made for effective treatment condition.

Therapeutic measures

Hallux valgus is treated with symptomatic and surgical method treatment. The conservative method does not lead to getting rid of visible manifestations, but stops further development pathology. Elimination of symptoms and correction of the foot using products medical purposes allows you to maintain the condition of the metatarsophalangeal joint at the same level.

Surgical treatment eliminates the defect and returns the foot to its previous appearance. A person no longer needs specialized shoes or silicone correctors to separate his toes. It becomes possible to wear open shoes and not be embarrassed by disfigured feet.

Conservative treatment

Treatment without surgery is predominantly symptomatic. If pain occurs, the orthopedist prescribes analgesics(Analgin, Baralgin) or non-steroidal anti-inflammatory drugs (Ketoprofen, Diclofenac) to eliminate pain syndrome. Medications are used not only in tablet form, but also local influence ointments or gels (Bystrumgel, Nise, Dolobene), therapeutic effect intensifies.

A history of gouty attacks will require the administration of Colchicine in the first hours after the onset severe pain, or Indomethacin, which is used for intolerance to the first drug. In the presence of an infectious factor, treatment is supplemented with antibiotics (Azithromycin Cephalexin). If the measures described above are ineffective, glucocorticosteroids (Prednisolone, Hydrocortisone) are injected into the diseased joint to combat inflammation and swelling.

Foot correction with orthopedic products

Stopping the growth of the bone around the big toe is only possible with the constant use of orthopedic insoles. main reason pathology (flat feet) is treated by correcting the arches of the feet medical products. The insole is designed to support the foot in sagging areas, restoring its physiological curves, and unload the foot, taking the bulk of the load on itself.

The doctor selects the right insole after a detailed examination of the person’s foot. Taking into account the degree and shape of flat feet, an orthopedic product is recommended that will not only stop the growth of the “bump”, but also relieve pain and fatigue during movement.

Modern orthopedic companies offer a wide selection of insoles. For transverse flatfoot, the insole must have a pronounced metatarsal roller, which provides support for the transverse arch of the foot. Considering the type of flatfoot (static or dynamic), you can choose soft (ORTO Mix, Trives ST-111) or hard (ORTO Concept, Trives ST-105k) insoles, depending on the material from which the orthopedic structure is made.

To prevent rubbing of the surface of the bunion in shoes, silicone toe separators or bunion protectors are used to protect the overgrowth of the toes. outside. To return the finger to its physiological state, in a state of rest (during sleep or rest), a special orthosis is put on, which moves the finger and fixes it in correct position. A contraindication for this method of treatment is pain when moving a finger with static flat feet, when ossification of the joints of the foot appears.

Walking on an orthopedic mat with bare feet, rolling a bottle or a massage roller with your foot will help improve the condition of your feet.

Surgical therapy

Surgical treatment consists of removing the growth on the big toe. Excision is performed through a small incision in the area of the “bump”; if necessary, surgeons reconstruct the thumb and metatarsal bone.

Rehabilitation after surgery takes about two months. All this time, the operated leg must be in a special bandage or shoes with a rigid sole. A month and a half after the operation, the doctor prescribes orthopedic insoles, which you will have to wear daily so that the condition of the bunion does not return.

Preventive actions

It is important to take care of the prevention of hallux valgus in advance when the legs do not show signs of bone changes:

eat right, maintaining weight within normal limits;
choose comfortable shoes that are close to orthopedic standards;
use orthopedic insoles to prevent flat feet;
to improve blood circulation, walk barefoot on sand or pebbles;
Regular examination by an orthopedist will help identify incipient flat feet and promptly correct the foot to prevent bone growth.

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What to do if a bone in your foot grows and hurts. Bulging of the bunion at the base of the big toe is a common problem that can cause various reasons, and in order to get rid of it, you must first eliminate its cause and only after that can you begin full treatment.

Many women suffer from growing and painful bones located in the area where the first big toe connects to the foot. Protrusion can spoil the appearance of beautiful female legs and will force you to part with your shoes and sandals forever. This is one of those problems that is very easy to deal with at the initial stage, but impossible to do without surgical treatment when profound changes have occurred.

Expert opinion

Alexander Vitalievich

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Bone protrusion is considered one of the most common problems faced by high heel lovers.

The first sign of the disease is pain when wearing tight shoes. However, as the disease worsens, the pain syndrome becomes so intense that it occurs even when wearing soft indoor slippers. What to do if a bone in your foot grows and hurts, and most importantly, how to prevent the development of the disease?

- a rather painful cosmetic defect that brings incredible suffering to its owner. Externally, all bumps, regardless of the cause that caused them, are very similar and have similar symptoms: they cause intense pain, interfere with walking, and bleed when rubbed. In 98% of cases, growths develop in women, and only 2% in men.

Expert opinion

Alexander Vitalievich

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In order to avoid severe deformation and not bring the situation to a critical point, at the first symptoms of the disease, seek help from a specialist who will prescribe treatment.

Causes

Initially, several main reasons for the formation of hallux valgus can be identified:

Excess weight has Negative influence on all systems and organs of our body, but the legs suffer the most from it.
Incorrectly selected shoes. Prolonged wearing of shoes that are too narrow, tight or with high heels invariably leads to foot deformation. When purchasing shoes, you must try them on carefully. If the model causes discomfort and pain, then it is better to refuse to purchase it. The likelihood of bunion formation can be reduced by purchasing comfortable, high-quality shoes with low heels.
Hereditary predisposition. If one of your close relatives suffers from hallux valgus, then there is a very high probability that, in the presence of accompanying factors, you may also develop such a pathology over time. Systematic implementation of special exercises will help you avoid health problems in the future.
Injuries. The cause of the development of the disorder may be a fracture, dislocation, subluxation and bruise of the big toe or the area where it attaches to the foot. Deformation can be caused by damage that leads to even the slightest displacement.
Flat feet. Those who suffer from this disorder are also susceptible to developing hallux valgus. Flat feet is a disease that you need to learn to live with.

Expert opinion

Alexander Vitalievich

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The disease itself can cause the development of serious disorders.

Only systematic execution preventive measures, such as special exercises and massage will help prevent the development of the disease.

Who is sick

The disease primarily affects older people. Almost every third person who has reached retirement age suffers severe pain caused by a protruding bone.
The first symptoms of hallux valgus can make themselves felt as early as 30 years of age, and gymnasts and ballerinas begin to get sick at a young or even childhood age.

What do you need

The effectiveness of treatment for hallux valgus depends on the attitude of the patient himself. The doctor will not be able to help if the patient does not systematically follow all the doctor’s instructions.

The beginning of healing

Excellent results are obtained by wearing an orthopedic bandage that fixes the bone. Developed various options devices that differ from each other in price and method of fixing the finger. Despite such diversity, all types of orthopedic bandages have one goal in common - keeping the joint in the correct physiological position and preventing protrusion.

Special insoles designed to be placed in shoes. During the day, this insole provides massage and helps to relax your feet. With the help of the insole, the foot takes a comfortable position, which has a positive effect on its muscles, bones and joints.

Systematic foot massage not only relieves fatigue or relaxes the foot muscles, but also helps strengthen them. Strong muscles will not allow the bone to take an unnatural position.

Expert opinion

Alexander Vitalievich

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Special therapeutic exercises also aimed at strengthening the foot muscles.

Their constant implementation will definitely help defeat the disease.

Normalization of weight. Every extra kilogram puts additional stress on your legs. Getting rid of extra pounds can also be called part of a treatment program that is aimed at correcting deformity.

Symptoms

The fact that the bone has begun to grow will be indicated by redness of the skin and pain in the area where the toe connects to the foot. The intensity of pain may increase with prolonged walking or physical activity. In addition to pain, there is a feeling of bulging in this area. The disease is characterized by a rapid course and, as a rule, very little time passes from the onset of the first symptoms until the moment when a person cannot put on his favorite shoes.

Deformation degrees

The first degree is characterized by the development of deformation not exceeding 20 degrees. Visually, the changes may not yet be noticeable, and excessive fatigue in the legs may occur even with short walking.

The second degree is observed with a curvature of 20 to 30 degrees. This degree is characterized by the development of pain during prolonged walking, and the protrusion becomes noticeable during examination.

The third degree is observed when bulging up to 50 degrees. The patient complains of pain even with minor physical activity. A person is forced to completely stop wearing hard leather models. Movement is only possible in soft shoes without heels.

The fourth degree is characterized by the development of deformation of more than 50 degrees. The patient constantly suffers from intense pain in the foot, which occurs not only during physical activity, but also at rest. In addition to pain, swelling of the foot develops.

A bone that appears and gradually grows near the big toe most likely indicates that the patient has transverse flatfoot. This pathology is the most common deformation of the musculoskeletal system and accounts for about 10% of all orthopedic diseases. The disease is characterized by a progressive course (the bone on the foot near the big toe continues to grow). Transverse flatfoot is recorded mainly in women (55.2% versus 38.1% in men). The formation of a bone or lump (the so-called hallux valgus) is an early symptom of an existing disease and indicates damage to the 1st metatarsophalangeal joint.

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Why does it occur

There are many theories explaining the origin of the development of transverse flatfoot in humans. Today, doctors believe that this disease develops under the influence of many factors (polyetiological theory). According to the latter, the following factors exist:

predisposing - anatomical, constitutional (congenital weakness of the ligamentous and tendon apparatus of the foot, worsening with age) and supporting features of the foot;
producing - static and dynamic overloads (long standing on the feet and gait patterns lead to weakening of the muscular system, which ultimately leads to changes in the muscles and ligaments of the foot), the use of irrational shoes.

Therefore, the causes of the development of transverse flatfoot can be divided into external and internal.

This disease is extremely rare as a congenital form.

The internal reasons are the following:

1. hereditary constitutional predisposition;
congenital dysplasia of the osteoarticular apparatus of the foot, the most likely signs of which are the following:
- significant lengthening or shortening of the 1st metatarsal bone;
- excessive bevel of the gap of the first metatarsocuneiform joint;
- presence of additional sesamoid bones.
3. primary weakness of the ligamentous-muscular apparatus of the foot.

TO external reasons that contribute to the development of this disease include overload associated with an increase in a person’s body weight, with playing sports, profession or housekeeping, with wearing irrational shoes (with a pointed toe and high heels), etc. The negative impact of the latter is so great that some scientists even consider it as the main reason for the formation of deformation.

Also, regular wearing of such shoes leads to a sharp increase in the load on the heads of the metatarsal bones and has a beneficial effect on the appearance and progression of deformity.

The metatarsal bones are held in the correct position by the fascia and plantar aponeurosis. Therefore, first of all, this disease should be considered from the standpoint of manifestation of insufficiency of the ligamentous apparatus against the background of weakness of the muscles of the foot and lower leg.

On one of her programs, even Elena Malysheva admitted that she suffers from this disease.

How the disease develops

To better understand how the disease develops, it is worth considering what bones the foot consists of.

Bones of the foot. View from above

It should be remembered that transverse flatfoot is a progressive disease. Therefore, if the patient does not follow the doctor’s recommendations, the bone on the big toe will continue to grow with other ensuing consequences.

Bones of the foot. Bottom view

Normally, the sesamoid bones are enclosed in the tendons of both heads of the flexor pollicis brevis, and the tendon of the flexor pollicis longus is firmly fixed between them (the so-called “hammock”).

“Hammock” of the first metatarsal bone: 1 - tendon of the adductor pollicis muscle; 2 - flexor pollicis longus tendon; 3 - tendon of the abductor pollicis muscle; 4 - tendons of both heads of the short flexor pollicis

In the process of development of this pathology, the main element is the spreading of the forefoot (i.e., divergence in horizontal plane metatarsal bones). Most often it occurs due to inward deviation of the 1st metatarsal, sometimes in combination with outward deviation of the 5th metatarsal.

Progression of inward deviation of the 1st metatarsal bone leads to subluxation and dislocation of the sesamoid bones. The latter shift to the area of the 1st intermetatarsal space. This leads to an outward displacement of the tendons that are in conjunction with the sesamoid bones. As a result, the head of the 1st metatarsal bone separates from its “hammock”.

As a result, the extensors and flexors of the thumb acquire an additional, unusual function of abductors (that is, abduction), leading to internal deviation of the thumb (halus valgus), which leads to the appearance of a lump or bone near it.

As a result of the interaction of the load forces on the first metatarsal bone and the ground reaction, a moment of force arises that promotes internal rotation of the 1st metatarsal bone and big toe. As a result of this, as well as subluxation and dislocation in the metatarsal-sesamoid joint, a significant decrease in the supporting function of the head of the 1st metatarsal bone is formed. This leads to a sharp increase in the load on the heads of the 2nd and 3rd metatarsal bones with the development of painful calluses (so-called corns) on the sole of the foot.

Corns

The head of the 1st metatarsal bone, protruding inward, is subject to constant pressure from the shoe. As a result, osteochondral exostosis appears along its inner edge and gradually increases in size (bone growth from a gradually ossifying cartilage tissue), and above it there is an often inflamed joint capsule ( chronic form bursitis).

Similar changes are sometimes observed in the area of the head of the 5th metatarsal bone, which is explained by its significant deviation outward. At the same time, the little finger deviates inward. IN foreign literature The pathology described above is called “tailor's bursitis.”

With transverse flatfoot, an increase in the load on the heads of the middle bones of the metatarsus creates excessive constant pressure on the flexor tendons of the 2nd and 3rd fingers. This causes a reflex contraction of the corresponding muscles and leads to the development of hammertoe deformity. Another reason for the development of this defect is the displacement of the middle fingers. thumb foot, which deviates outward.

Hammer fingers

This specific deformity is characterized by flexion at the proximal interphalangeal joint and extension at the metatarsophalangeal joint. Sometimes an extension or flexion position in the distal interphalangeal joint is additionally added.

As the disease progresses, persistent joint contractures of the hammertoes form, and painful calluses from shoe pressure develop on their dorsum. In the future, a dislocation of the finger towards the rear (“clawed” finger) may form, and the development of osteoarthritis in the deformed joints increases the pain syndrome.

"Clawed" finger

Thus, transverse flatfoot is a multicomponent deformity of the forefoot. The most important elements of the latter, in addition to transverse flatness, are dislocation of the sesamoid bones of the metatarsophalangeal joint and excessive internal rotation of the 1st metatarsal bone.

In most cases, the consequence of transverse flatfoot is deviation of the big toe outward and/or little toe inward, and hammertoe deformity of the middle toes.

Classification

Transverse flatfoot and hallux valgus are classified differently depending on the severity of pathological changes.

HVA - thumb deviation angle (normally up to 15 degrees). IMA - angle between the 1st and 2nd metatarsal bones (normally 8-10 degrees)

According to the degree (sometimes referred to as stages) of forefoot deformation (determined by X-ray data), the following are distinguished:

first (weak) - HVA does not exceed 30 degrees, and IMA is within 9-12 degrees;
second (moderately expressed) - HVA reaches 40 degrees, and IMA increases to 13-16 degrees;
third (sharply expressed) - HVA is over 40 degrees, and IMA increases to 16 degrees or more.

Degrees of hallux valgus: 1st (top picture), 2nd (bottom picture on the left), 3rd (bottom picture on the right)

Transverse flatfoot in the form of deformation of the forefoot is as follows:

Unfixed (“soft” foot) - the transverse flatness of the foot is completely eliminated, and the big toe is easily moved to its normal position using manual correction.
Fixed (“rigid” foot) - an attempt to reduce the diameter of the foot and move the big toe to a normal position using manual correction does not give positive results.

Unfixed form. On the left is the foot before correction of the deformity. On the right - foot after manual correction

Treat this disease yourself at home, and even more so resort to folk remedies highly not recommended. You should consult an orthopedist.

Fixed form. On the left is the foot before correction of the deformity. On the right - the foot when attempting manual correction

Transverse flatfoot is divided depending on the location of the deformity into unilateral and bilateral.

Clinical manifestations and diagnosis

The diagnosis of “transverse flatfoot” and “halus valgus” is established based on the results of a clinical examination, X-ray studies. This pathology is confirmed using podometric and plantographic (measurement of parameters and graphic image feet) research.

During a clinical examination, the doctor finds out what the patient is complaining about, and also determines the type of transverse flatfoot according to the classification. The patient's main complaints are the following:

pain;
change in the location of the bones of the forefoot;
problems in wearing and selecting standard shoes (this forces patients to use shoes bigger size with a loose toe, and for women - to almost completely abandon shoes with heels);
cosmetic defect (patients indicate the presence of “ugly bones on the legs”).

Painful sensations with transverse flatfoot, they are more often localized on the plantar surface of the foot under the heads of the middle metatarsal bones and medial surface heads of the 1st metatarsal bone. Mostly the pain is periodic and occurs when walking and standing, accompanied by increased fatigue legs Pain can sometimes radiate to the knee joint or lower leg area.

Typically, the duration and intensity of pain increases as the deformity progresses. Again, the opposite is observed when, with severe degrees of this disease, pain is not expressed.

With transverse flatfoot, the foot deformity has certain characteristics. They are the following:

expansion of the forefoot;
outward deviation of the thumb with its internal rotation;
corns on the sole in the area of the heads of the middle metatarsal bones;
osteochondral exostosis of the head of the 1st metatarsal bone with signs of chronic bursitis;
hammertoe deformity of the middle toes, which is accompanied by the development of corns on the dorsal surface of the deformed toes;
deviation inward of the little finger with the presence of exostosis and symptoms of bursitis.

The following X-ray examinations are used for transverse flatfoot:

x-ray of the foot in a direct projection - allows you to determine the type of transverse flatness, as well as HVA and IMA;
X-ray of the foot in the axial projection - allows you to determine the degree of displacement of the sesamoid bones of the 1st metatarsophalangeal joint in the area of the intermetatarsal space and evaluate the angle of rotation of the 1st metatarsal bone.

When performing podometry, the Friedland transverse index is calculated, which will exceed the norm depending on the degree of deformation.

The plantography method allows you to detect overload zones in the forefoot area and also calculate HVA.

Another reason for bone growth

There are pathological conditions that can be confused with early manifestations transverse flatfoot (halus valgus).

If there is an expansion of the forefoot (in the area of the metatarsal heads), then this may be a consequence of osteofibrous growths in the area of the head of the 1st metatarsal bone. The latter simulate the outward deviation of the thumb by 15-20 degrees.

The spread of these growths to the surface of the joint leads to subluxation proximal phalanx first finger. This leads to a deviation, sometimes reaching 30 degrees. With this pathology, no signs of transverse flatfoot are found and no deformation of the other toes is observed. This pathological condition occurs relatively infrequently, in approximately 1.5% of cases.

This pathology is much less common on the little finger.

In the case of this pathology, Schede's operation is a radical intervention. This is due to the fact that the supporting function of the foot is not impaired in this disease and removal of the growths completely cures the patient of this pathology. A similar operation is performed when the head of the 5th metatarsal bone is affected.

Treatment

Toe deformities and transverse flat feet are treated mainly with surgical intervention. At the initial manifestations of the disease, it is recommended to resort to conservative therapy. This mainly occurs in old age, in adolescents, in the presence of contraindications to surgery, as well as in the postoperative period.

To return the thumb to its previous position, use different kinds interdigital inserts, perform daily exercise therapy, special splints for the big toe and foot. To form a transverse arch, they resort to:

circular bandaging of the foot in the area of the heads of the metatarsal bones;
using special orthopedic insoles or ties with a Seitz roller under the heads of the 2nd-3rd metatarsal bones.

If the deformity is severe, orthopedic shoes are used. Below is an example of an auxiliary treatment method for this disease.

If you have a bone near your big toe, Elena Malysheva and other qualified doctors recommend purchasing orthopedic insoles with a Seitz cushion, which additionally helps to stop the progression of the disease in combination with lifestyle changes (stop wearing unsustainable shoes).

Special splint for the big toe with a special intertoe insert

Foot baths, various physiotherapy procedures, corrective gymnastics in combination with massage can only temporarily get rid of pain and exacerbation of bursitis in the area of the head of the 1st or 5th metatarsal bone. It is impossible to eliminate the deformity with conservative treatment.

Surgery

Today modern concept surgical treatment states that the operation must be radical, that is, eliminate the root cause of toe deformities - transverse flatfoot. Since in most cases with this pathology there is an inward deviation of the 1st metatarsal bone, the main direction of surgical intervention is to eliminate its incorrect position.

Depending on the shape of transverse flatfoot, different surgical approaches are used, which are presented in the table below.

If there are contraindications to radical surgery or in elderly patients, palliative treatment may be performed surgery(improving the patient’s quality of life, but does not eliminate transverse flatfoot). The essence of this surgical intervention is to correct finger deformities that cause the greatest suffering to a person (halus valgus, hammertoes).

Hallux valgus is a disease in which a bone on the foot grows on the side, causing a change bone structure the remaining fingers. It is diagnosed more often in females due to wearing high-heeled shoes. This disease is dangerous because it can lead to deformation of the fingers and uneven load on the human body. Therefore, when a bone begins to grow, you need to seek help from a professional.

Why does bone grow?

What to do to treat bunions?

First steps

When a bone in your foot begins to grow or has already grown, it needs to be realigned. For this, orthopedists have invented a special one, which is attached to the foot near the big toe. This device effectively helps in the initial stages, reducing pain and restoring the original position of the bone joint on the foot. Soft and hard leg clamps have also been developed. To begin with, you can use them: the first - during the day, and the second - at night. In order not to develop a disease that will require surgical intervention, you need not only to wear special braces, but also to monitor your weight and be sure to wear comfortable shoes.

Folk remedies

Bile can be used as compresses.

In the fight against education, you can use unconventional methods treatment. For example, pharmaceutical bile, which is used as a compress at night. To do this, you will need cotton wool or a cotton pad soaked in this liquid. It needs to be applied to the diseased formation, and then wrapped in warm clothes. Wool socks will do. Tincture of iodine or others medicinal substances based on an alcohol solution, they are good for treating bones. To do this, you need to dry the dandelion flowers and then pour them with iodine tincture for no more than 4 days. Apply on sore spot after steaming, drawing a kind of grid overnight. Iodine tincture can be used in combination with other components, such as aspirin, laundry soap, camphor oil and even lemon.

Surgical methods

Used in extreme cases when other treatments fail effective result. For example, when a patient long time did not visit a doctor, while ignoring pain and discomfort. As a result, the disease was in an advanced stage. The operation will be needed to restore the functionality of the foot, correct the position of the phalanges, and also eliminate painful symptoms. To do this, the doctor must remove the protruding parts of the bone, then fix the finger in its natural position and only then stabilize the joint. An example of such an operation is an osteotomy, during which a Z-shaped incision is made to allow the lump to be reduced.

Other treatments

Methods such as physiotherapy and therapeutic exercises are additional during complex therapy. The following exercises will help develop your leg muscles and improve their motor abilities:

turning the body to the sides with bent toes;
walking on the outside of the foot for 20 minutes;
picking up napkins scattered on the floor with your feet;
rolling a rolling pin;
lifting and holding small objects between feet;
rolling river pebbles in a basin of warm water.

How to prevent the growth of a bunion on the foot?

Particular attention should be paid women's shoes on stiletto heels. It is advisable that the heel be no more than 5-7 cm. In case of long-term stay in heels, it is recommended to take replacement shoes.

The main rule for preventing the occurrence of a bump on the big toe is to wear comfortable shoes. This means not only comfort, but also the quality of the material made, the width of the sole to prevent compression of the foot. TO general rules prevention includes weight control, active pastime, timely seeking help from a specialist in case of suspected deterioration of the endocrine system, as well as flat feet.