Abstract
BackgroundHallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis. The link between structural HV deformity and foot pain is unclear. This study investigated possible explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of joint degeneration.MethodsParticipants were 60 adults (53 female) with HV aged 20 to 75 years. Participant demographics and a range of radiographic, clinical and functional measures were considered potential correlates of foot pain. Self-reported foot pain (visual analogue scales and a dichotomous definition) was considered the dependent variable. Multivariate modelling was used to determine which characteristics and measures explained pain, with univariate analyses first used to screen potential variables.ResultsApproximately 20 to 30% of the variance in foot pain associated with HV could be explained by patient characteristics such as poorer general health status, lower educational attainment and increased occupational physical activity levels, in combination with some dynamic physical characteristics such as hallux plantarflexion weakness and reduced force-time integral under the second metatarsal during gait. Neither increasing lateral deviation of the hallux (HV angle) nor presence of first metatarsophalangeal joint osteoarthritis was associated with foot pain.ConclusionsThis study shows that passive structural factors, including HV angle, do not appear to be significant correlates of foot pain intensity in HV. Our data demonstrate the importance of considering patient characteristics such as general health and physical activity levels when assessing foot pain associated with HV.
Highlights
Hallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis
In combination these factors explained approximately 20 to 30% of the variance in foot pain associated with HV
Foot pain and disability associated with HV must be evaluated in the context of patient characteristics such as general health status and occupational physical activity levels
Summary
Hallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis. This study investigated possible explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of joint degeneration. Hallux valgus (HV) is a highly prevalent forefoot deformity [1], presenting with lateral deviation of the first toe and progressive subluxation of the first metatarsophalangeal (MTP) joint. A study of pain symptoms in HV should investigate local factors as well as patient characteristics. This cross-sectional study examined potential explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of OA, as well as foot and ankle factors and participant characteristics. Differences between participants with and without disabling foot pain were investigated
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