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Bunions take toll on life

Bunions, a common but painful deformity of the foot, are more likely to develop in older people and women. And the more severe the bunion, the more likely the person is to have pain in other parts of the body.

Bunions take toll on life

Bunions, a common but painful deformity of the foot, are more likely to develop in older people and women. And the more severe the bunion, the more likely the person is to have pain in other parts of the body, leading to declines in both general and foot-specific health-related quality of life.

A bunion (also called hallux valgus) is a common foot condition that is caused when the big toe bends in towards the smaller toes. This condition develops over time and is accompanied by a painful soft tissue and boney protrusion, commonly known as a bunion. As the deformity progresses the lateral displacement of the hallux (big toe) begins to interfere with normal alignment and function of the smaller toes, leading to further deformities such as hammer toe or claw toe, altered weight-bearing patterns, and the development of corns and calluses. Family history, wearing high heeled shoes or shoes that are too narrow and flat footedness have all been suggested to contribute to the development of bunions.

Researchers collected data from 2,831 people, aged 56 years and older, who were taking part in an osteoarthritis research project in the United Kingdom. They examined the prevalence of and factors associated with hallux valgus, and assessed the severity of deformity on general and foot-specific health-related quality of life. The team established five severity grades of hallux valgus, corresponding to the angle of deformity of 0, 15, 30, 45, and 60 degrees, with one representing no angle and five indicating the most severe deformity.

It was found that just over one-third of the participants had some degree of bunion, with a greater prevalence among women and older people. Pain in other parts of the body beyond the foot was associated with increased bunion severity. Individuals with bunion had greater impairment and in those who reported foot pain in the past 12 months, those with bunion deformity had a higher score in both the pain and function subscales. The impact of increasing hallux valgus severity on health-related quality of life was independent of age, sex, education, BMI, and pain in other regions, and extended beyond pain and physical function to affect general health, vitality, social function, and mental health.

The study concluded that hallux valgus was a significant and disabling musculoskeletal condition that affects overall quality of life. Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes that extend beyond merely localized pain relief.
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