Hallux valgus: pay attention to high heels!

The bunion is not only an aesthetic problem, but also a real disease that can affect anyone.
It develops over time, resulting in changes in the structural alignment of the bones of the foot reflecting a change in anatomy. The condition is more likely to affect women, mainly due to their use of high heels, and cause serious problems such as pain and intense difficulties walking. Dr.Leonardo Maradei, responsible for foot surgery in Humanitas Research Hospital, speaks of the hallux valgus in the Italian magazine “Saper Vivere” (Knowing how to live).

What is this disease? 

Bunions take time to develop and most people do not notice any symptoms until the condition becomes more severe. The main symptoms associated with hallux valgus include pain, discomfort, redness, burning sensation, swelling as well as difficulty walking. high heelsMore specifically, in terms of symptoms and effects, hallux valgus is a deviation of the big toe towards the other toes, which is evident, says Dr. Maradei, with “a medial protrusion of the metatarsal phalangeal joint, that with the progression of the disease can cause bursitis and loss of load on the foot, often associated with overload on 2 to 3 metatarsal joints and thus the condition is characterized by the so-called “hammer toes.”

Hallux valgus, a difficult disease to prevent

Unfortunately, hallux valgus is difficult to prevent. 
The main cause of bunions is poor footwear choice such as shoes that do not fit properly, shoes that are too narrow or too tight, or shoes that are too small. Other causes include family history, since bunions may be hereditary, as well as weight problems, congenital malformations, posture and muscle tone problems, foot trauma or they may be the result of an inflammatory condition such as arthritis – says Dr. Maradei. Furthermore, hallux valgus may also be associated with bursitis, tendonitis or metatarsalgia. 

The diagnosis of hallux valgus is generally determined through typical observation; however, medical practitioners may use particular techniques that are useful in evaluating the ability of movement of the big toe. Moreover, the extent of the condition and deformity of the foot may be confirmed by radiograph (X-Ray) of the affected foot.

Not all cases of hallux valgus produce the same symptoms. The constant sign, for all who are affected, is the presence of pain; however, the pain can vary significantly, according to the specialist: “Some patients complain of pain in the second toe, rather than the big toe. Others experience a shock of intense pain in the absence of obvious bone deviations. Moreover, others denounce deformity not only to the big toe, but also to the other fingers.”

Treatment of hallux valgus

Symptoms of hallux valgus, concludes Dr. Maradei, can be alleviated “by wearing comfortable shoes or applying a bandage to keep the foot in a normal position, reducing the stress on the big toe or by using special insoles”. These are non-surgical treatments that may also include custom-made orthotic devices; ice to reduce pain and inflammation, and over-the-counter anti-inflammatory drugs. If these remedies do not help, a doctor may recommend changing the bone deformity and returning the bones to their appropriate anatomical position with percutaneous surgery, which is performed through small incisions in the skin and with the use of special tools “guided” by X-ray images. However, the type of procedure may still depend on the extent of the deformity, age, activity level, and the overall health of the patient.


Humanitas is a highly specialized Hospital, Research and Teaching Center. Built around centers for the prevention and treatment of cancer, cardiovascular, neurological and orthopedic disease – together with an Ophthalmic Center and a Fertility Center – Humanitas also operates a highly specialised Emergency Department.