Flat Feet and Hallux Valgus: Treatment Options and Advice

Hallux valgus with flatfoot?

Recently, I have been experiencing pain on the outer side and bottom of my right foot and have sought medical attention.
The doctor diagnosed me with flat feet, but my symptoms include thickened skin and calluses on the heel and forefoot, with a hollow space in the center of the foot that does not touch the ground.
Does this still qualify as flat feet? Should I choose shoes with cushioning? Additionally, I have bunions on both feet, and the X-ray shows an angle of 16 degrees of hallux valgus.
Does this require treatment? Should I purchase a bunion corrector to wear during the day and night? My 5-year-old daughter also has bunions and some flat feet.
Does she need treatment, or would wearing commercially available corrective shoes help improve her condition?

nitimm, 30~39 year old female. Ask Date: 2010/11/05

Dr. Li Wenhong reply Orthopedics

Based on the symptoms you described, it may not be flatfoot; a detailed evaluation should be conducted in person at a clinic.
For your symptoms, you can start using cushioned shoes or custom orthotics.
As for the treatment of hallux valgus, it depends on whether there are symptoms (such as bursitis, swelling, and pain on the medial side of the metatarsophalangeal joint of the big toe) and whether it affects shoe fitting and walking.
Generally, it is recommended to treat symptoms with anti-inflammatory and pain relief medications, wear shoes with a wider toe box and flatter soles.
Hallux valgus splints are primarily intended to prevent further worsening of the condition rather than to correct it; if shoe-wearing habits do not improve, the condition will continue to progress.
For children with flatfoot and hallux valgus, if there are no symptoms, appropriate footwear is usually sufficient, and there is no need for custom corrective shoes.
Off-the-shelf corrective shoes that are ergonomically designed are acceptable if reasonably priced.

Reply Date: 2010/11/05

More Info

Flat feet, also known as pes planus, is a condition where the arches of the feet are flattened, allowing the entire sole to make contact with the ground. This condition can lead to various symptoms, including pain in the heel and the ball of the foot, as well as the development of calluses due to abnormal pressure distribution. In your case, the presence of thickened skin and calluses on the heel and the ball of your foot, along with the sensation of a "hollow" center, suggests that you may indeed have flat feet.
The pain you are experiencing on the outer side and bottom of your right foot could be attributed to the altered biomechanics associated with flat feet. When the arch is flattened, it can lead to overpronation, where the foot rolls inward excessively during walking or running, causing strain on the ligaments and tendons in the foot and ankle.

Regarding your question about footwear, it is advisable to choose shoes that provide adequate support and cushioning. Shoes with built-in arch support or those designed specifically for flat feet can help alleviate discomfort. Air-cushioned shoes can also provide additional comfort and shock absorption, which may be beneficial for your condition.

You mentioned having hallux valgus, or bunions, with a 16-degree angle of deviation. This degree of deformity may not require immediate surgical intervention, especially if it is not causing significant pain or functional impairment. However, if you are experiencing discomfort, treatment options may include the use of orthotic devices, such as bunion splints or toe spacers, which can help realign the toes and reduce pressure on the bunion. Wearing wider shoes that accommodate the bunion can also help minimize pain.

As for your daughter, it is not uncommon for children to exhibit signs of flat feet or hallux valgus. In many cases, children outgrow these conditions as their feet develop. However, if she is experiencing pain or if the deformity appears to be worsening, it would be prudent to consult a pediatric podiatrist. They can assess her condition and recommend appropriate interventions, which may include custom orthotics or specific exercises to strengthen the foot muscles.

In terms of treatment, here are some options to consider:
1. Orthotic Devices: Custom or over-the-counter orthotic inserts can provide arch support and help distribute pressure more evenly across the foot.

2. Footwear: Invest in supportive shoes that fit well and provide adequate cushioning. Avoid high heels and shoes with narrow toe boxes.

3. Physical Therapy: A physical therapist can design a program of exercises to strengthen the muscles of the foot and improve flexibility, which may alleviate some symptoms.

4. Bunion Splints: These can be worn at night to help realign the toe and reduce discomfort.

5. Surgery: In severe cases where conservative treatments fail, surgical options may be considered to correct the deformity.

6. Monitoring: Regular check-ups with a healthcare provider can help monitor the progression of the condition and adjust treatment as necessary.

In conclusion, while flat feet and hallux valgus can lead to discomfort, there are various treatment options available. It is essential to consult with a healthcare professional who specializes in foot conditions to determine the best course of action for both you and your daughter. Early intervention can often lead to better outcomes and improved quality of life.

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