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Published in: Journal of Foot and Ankle Research 1/2014

Open Access 01-12-2014 | Research

Correlates of foot pain severity in adults with hallux valgus: a cross-sectional study

Authors: Sheree E Hurn, Bill T Vicenzino, Michelle D Smith

Published in: Journal of Foot and Ankle Research | Issue 1/2014

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Abstract

Background

Hallux 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.

Methods

Participants 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.

Results

Approximately 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.

Conclusions

This 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.
Literature
1.
go back to reference Nix S, Smith M, Vicenzino B: Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010, 3: 21-CrossRefPubMedPubMedCentral Nix S, Smith M, Vicenzino B: Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 2010, 3: 21-CrossRefPubMedPubMedCentral
2.
go back to reference D'Arcangelo P, Landorf KB, Munteanu SE, Zammit GV, Menz HB: Radiographic correlates of hallux valgus severity in older people. J Foot Ankle Res. 2010, 3: 20-CrossRefPubMedPubMedCentral D'Arcangelo P, Landorf KB, Munteanu SE, Zammit GV, Menz HB: Radiographic correlates of hallux valgus severity in older people. J Foot Ankle Res. 2010, 3: 20-CrossRefPubMedPubMedCentral
3.
go back to reference Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR: Cross-sectional analysis of foot function, functional ability, and health-related quality of life in older people with disabling foot pain. Arthritis Care Res (Hoboken). 2011, 63: 1592-1598.CrossRef Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR: Cross-sectional analysis of foot function, functional ability, and health-related quality of life in older people with disabling foot pain. Arthritis Care Res (Hoboken). 2011, 63: 1592-1598.CrossRef
4.
go back to reference Menz HB, Roddy E, Thomas E, Croft PR: Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken). 2011, 63: 396-404. Menz HB, Roddy E, Thomas E, Croft PR: Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken). 2011, 63: 396-404.
5.
go back to reference Menz HB, Tiedemann A, Mun-San Kwan M, Plumb K, Lord SR: Foot pain in community-dwelling older people: an evaluation of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford). 2006, 45: 863-867.CrossRef Menz HB, Tiedemann A, Mun-San Kwan M, Plumb K, Lord SR: Foot pain in community-dwelling older people: an evaluation of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford). 2006, 45: 863-867.CrossRef
6.
go back to reference Roddy E, Zhang W, Doherty M: Prevalence and associations of hallux valgus in a primary care population. Arthritis Care Res (Hoboken). 2008, 59: 857-862.CrossRef Roddy E, Zhang W, Doherty M: Prevalence and associations of hallux valgus in a primary care population. Arthritis Care Res (Hoboken). 2008, 59: 857-862.CrossRef
7.
go back to reference Cho NH, Kim S, Kwon DJ, Kim HA: The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg (Br). 2009, 91: 494-498.CrossRef Cho NH, Kim S, Kwon DJ, Kim HA: The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg (Br). 2009, 91: 494-498.CrossRef
8.
go back to reference Badlissi F, Dunn JE, Link CL, Keysor JJ, McKinlay JB, Felson DT: Foot musculoskeletal disorders, pain, and foot-related functional limitation in older persons. J Am Geriatr Soc. 2005, 53: 1029-1033.CrossRefPubMed Badlissi F, Dunn JE, Link CL, Keysor JJ, McKinlay JB, Felson DT: Foot musculoskeletal disorders, pain, and foot-related functional limitation in older persons. J Am Geriatr Soc. 2005, 53: 1029-1033.CrossRefPubMed
9.
go back to reference Nguyen USDT, Hillstrom HJ, Li W, Dufour AB, Kiel DP, Procter-Gray E, Gagnon MM, Hannan MT: Factors associated with hallux valgus in a population-based study of older women and men: the MOBILIZE Boston Study. Osteoarthritis Cartilage. 2010, 18: 41-46.CrossRefPubMed Nguyen USDT, Hillstrom HJ, Li W, Dufour AB, Kiel DP, Procter-Gray E, Gagnon MM, Hannan MT: Factors associated with hallux valgus in a population-based study of older women and men: the MOBILIZE Boston Study. Osteoarthritis Cartilage. 2010, 18: 41-46.CrossRefPubMed
10.
go back to reference Garrow AP, Silman AJ, Macfarlane GJ: The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations. Pain. 2004, 110: 378-384.CrossRefPubMed Garrow AP, Silman AJ, Macfarlane GJ: The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations. Pain. 2004, 110: 378-384.CrossRefPubMed
11.
go back to reference Coughlin MJ, Jones CP: Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ank Int. 2007, 28: 759-777.CrossRef Coughlin MJ, Jones CP: Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ank Int. 2007, 28: 759-777.CrossRef
12.
go back to reference Barker K, Lamb S, Toye F, Jackson S, Barrington S: Association between radiographic joint space narrowing, function, pain and muscle power in severe osteoarthritis of the knee. Clin Rehabil. 2004, 18: 793-800.CrossRefPubMed Barker K, Lamb S, Toye F, Jackson S, Barrington S: Association between radiographic joint space narrowing, function, pain and muscle power in severe osteoarthritis of the knee. Clin Rehabil. 2004, 18: 793-800.CrossRefPubMed
13.
go back to reference Munteanu SE, Zammit GV, Menz HB: Factors associated with foot pain severity and foot-related disability in individuals with first metatarsophalangeal joint OA. Rheumatology (Oxford). 2012, 51: 176-183.CrossRef Munteanu SE, Zammit GV, Menz HB: Factors associated with foot pain severity and foot-related disability in individuals with first metatarsophalangeal joint OA. Rheumatology (Oxford). 2012, 51: 176-183.CrossRef
14.
go back to reference Kernozek TW, Elfessi A, Sterriker S: Clinical and biomechanical risk factors of patients diagnosed with hallux valgus. J Am Podiatr Med Assoc. 2003, 93: 97-103.CrossRefPubMed Kernozek TW, Elfessi A, Sterriker S: Clinical and biomechanical risk factors of patients diagnosed with hallux valgus. J Am Podiatr Med Assoc. 2003, 93: 97-103.CrossRefPubMed
15.
go back to reference Wen J, Ding Q, Yu Z, Sun W, Wang Q, Wei K: Adaptive changes of foot pressure in hallux valgus patients. Gait Posture. 2012, 36: 344-349.CrossRefPubMed Wen J, Ding Q, Yu Z, Sun W, Wang Q, Wei K: Adaptive changes of foot pressure in hallux valgus patients. Gait Posture. 2012, 36: 344-349.CrossRefPubMed
17.
go back to reference Riskowski J, Dufour AB, Hannan MT: Arthritis, foot pain and shoe wear: current musculoskeletal research on feet. Curr Opin Rheumatol. 2011, 23: 148-155.CrossRefPubMedPubMedCentral Riskowski J, Dufour AB, Hannan MT: Arthritis, foot pain and shoe wear: current musculoskeletal research on feet. Curr Opin Rheumatol. 2011, 23: 148-155.CrossRefPubMedPubMedCentral
18.
go back to reference Roddy E, Muller S, Thomas E: Onset and persistence of disabling foot pain in community-dwelling older adults over a 3-year period: a prospective cohort study. J Gerontol A Biol Sci Med Sci. 2011, 66: 474-480.CrossRefPubMed Roddy E, Muller S, Thomas E: Onset and persistence of disabling foot pain in community-dwelling older adults over a 3-year period: a prospective cohort study. J Gerontol A Biol Sci Med Sci. 2011, 66: 474-480.CrossRefPubMed
19.
go back to reference Tanamas SK, Wluka AE, Berry P, Menz HB, Strauss BJ, Davies-Tuck M, Proietto J, Dixon JB, Jones G, Cicuttini FM: Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care Res (Hoboken). 2012, 64: 262-268.CrossRef Tanamas SK, Wluka AE, Berry P, Menz HB, Strauss BJ, Davies-Tuck M, Proietto J, Dixon JB, Jones G, Cicuttini FM: Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care Res (Hoboken). 2012, 64: 262-268.CrossRef
20.
go back to reference Leveille SG, Guralnik JM, Ferrucci L, Hirsch R, Simonsick E, Hochberg MC: Foot pain and disability in older women. Am J Epidemiol. 1998, 148: 657-665.CrossRefPubMed Leveille SG, Guralnik JM, Ferrucci L, Hirsch R, Simonsick E, Hochberg MC: Foot pain and disability in older women. Am J Epidemiol. 1998, 148: 657-665.CrossRefPubMed
21.
go back to reference Hopson MM, McPoil TG, Cornwall MW: Motion of the first metatarsophalangeal joint: reliability and validity of four measurement techniques. J Am Podiatr Med Assoc. 1995, 85: 198-204.CrossRefPubMed Hopson MM, McPoil TG, Cornwall MW: Motion of the first metatarsophalangeal joint: reliability and validity of four measurement techniques. J Am Podiatr Med Assoc. 1995, 85: 198-204.CrossRefPubMed
22.
go back to reference Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: Development and validation of a questionnaire to assess disabling foot pain. Pain. 2000, 85: 107-113.CrossRefPubMed Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: Development and validation of a questionnaire to assess disabling foot pain. Pain. 2000, 85: 107-113.CrossRefPubMed
23.
go back to reference Roddy E, Muller S, Thomas E: Defining disabling foot pain in older adults: further examination of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford). 2009, 48: 992-996.CrossRef Roddy E, Muller S, Thomas E: Defining disabling foot pain in older adults: further examination of the Manchester Foot Pain and Disability Index. Rheumatology (Oxford). 2009, 48: 992-996.CrossRef
24.
go back to reference Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's Manual for the SF-36v2® Health Survey. 2007, QualityMetric Incorporated: Lincoln, RI, 2 Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's Manual for the SF-36v2® Health Survey. 2007, QualityMetric Incorporated: Lincoln, RI, 2
25.
go back to reference Baecke JAH, Burema J, Frijters JER: A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982, 36: 936-942.PubMed Baecke JAH, Burema J, Frijters JER: A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982, 36: 936-942.PubMed
26.
go back to reference Russell T, Jull G, Wootton R: Can the internet be used as a medium to evaluate knee angle?. Manual Ther. 2003, 8: 242-246.CrossRef Russell T, Jull G, Wootton R: Can the internet be used as a medium to evaluate knee angle?. Manual Ther. 2003, 8: 242-246.CrossRef
27.
go back to reference Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic classification of osteoarthritis in commonly affected joints of the foot. Osteoarthritis Cartilage. 2007, 15: 1333-1338.CrossRefPubMed Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic classification of osteoarthritis in commonly affected joints of the foot. Osteoarthritis Cartilage. 2007, 15: 1333-1338.CrossRefPubMed
28.
go back to reference Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic evaluation of foot osteoarthritis: sensitivity of radiographic variables and relationship to symptoms. Osteoarthritis Cartilage. 2009, 17: 298-303.CrossRefPubMed Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic evaluation of foot osteoarthritis: sensitivity of radiographic variables and relationship to symptoms. Osteoarthritis Cartilage. 2009, 17: 298-303.CrossRefPubMed
29.
go back to reference Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: The grading of hallux valgus. The Manchester Scale. J Am Podiatr Med Assoc. 2001, 91: 74-78.CrossRefPubMed Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: The grading of hallux valgus. The Manchester Scale. J Am Podiatr Med Assoc. 2001, 91: 74-78.CrossRefPubMed
30.
go back to reference Menz HB, Munteanu SE: Radiographic validation of the Manchester scale for the classification of hallux valgus deformity. Rheumatology (Oxford). 2005, 44: 1061-1066.CrossRef Menz HB, Munteanu SE: Radiographic validation of the Manchester scale for the classification of hallux valgus deformity. Rheumatology (Oxford). 2005, 44: 1061-1066.CrossRef
31.
go back to reference Redmond AC, Crosbie J, Ouvrier RA: Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech (Bristol, Avon). 2006, 21: 89-98.CrossRef Redmond AC, Crosbie J, Ouvrier RA: Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech (Bristol, Avon). 2006, 21: 89-98.CrossRef
32.
go back to reference Cornwall MW, McPoil TG, Lebec M, Vicenzino B, Wilson J: Reliability of the modified Foot Posture Index. J Am Podiatr Med Assoc. 2008, 98: 7-13.CrossRefPubMed Cornwall MW, McPoil TG, Lebec M, Vicenzino B, Wilson J: Reliability of the modified Foot Posture Index. J Am Podiatr Med Assoc. 2008, 98: 7-13.CrossRefPubMed
33.
go back to reference Menz HB, Munteanu SE: Validity of 3 clinical techniques for the measurement of static foot posture in older people. J Orthop Sports Phys Ther. 2005, 35: 479-486.CrossRefPubMed Menz HB, Munteanu SE: Validity of 3 clinical techniques for the measurement of static foot posture in older people. J Orthop Sports Phys Ther. 2005, 35: 479-486.CrossRefPubMed
34.
go back to reference McPoil TG, Vicenzino B, Cornwall MW, Collins N, Warren M: Reliability and normative values for the foot mobility magnitude: a composite measure of vertical and medial-lateral mobility of the midfoot. J Foot Ankle Res. 2009, 2: 6-CrossRefPubMedPubMedCentral McPoil TG, Vicenzino B, Cornwall MW, Collins N, Warren M: Reliability and normative values for the foot mobility magnitude: a composite measure of vertical and medial-lateral mobility of the midfoot. J Foot Ankle Res. 2009, 2: 6-CrossRefPubMedPubMedCentral
35.
go back to reference Beighton P, Bird HA, Grahame R: Hypermobility of joints. 1983, New York: SpringerCrossRef Beighton P, Bird HA, Grahame R: Hypermobility of joints. 1983, New York: SpringerCrossRef
36.
go back to reference Bennell KL, Talbot RC, Wajswelner H, Technovanich W, Kelly DH, Hall AJ: Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998, 44: 175-180.CrossRefPubMed Bennell KL, Talbot RC, Wajswelner H, Technovanich W, Kelly DH, Hall AJ: Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998, 44: 175-180.CrossRefPubMed
37.
go back to reference Nix S, Vicenzino BT, Smith MD: Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study. BMC Musculoskelet Disord. 2012, 13: 197-CrossRefPubMedPubMedCentral Nix S, Vicenzino BT, Smith MD: Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study. BMC Musculoskelet Disord. 2012, 13: 197-CrossRefPubMedPubMedCentral
38.
go back to reference deWin M, Theuvenet W, Roche P, deBie R, vanMameren H: The paper grip test for screening on intrinsic muslce paralysis in the foot of leprosy patients. Int J Lepr Other Mycobact Dis. 2002, 70: 16-24. deWin M, Theuvenet W, Roche P, deBie R, vanMameren H: The paper grip test for screening on intrinsic muslce paralysis in the foot of leprosy patients. Int J Lepr Other Mycobact Dis. 2002, 70: 16-24.
39.
go back to reference Menz HB, Zammit GV, Munteanu SE, Scott G: Plantarflexion strength of the toes: age and gender differences and evaluation of a clinical screening test. Foot Ankle Int. 2006, 27: 1103-1108.PubMed Menz HB, Zammit GV, Munteanu SE, Scott G: Plantarflexion strength of the toes: age and gender differences and evaluation of a clinical screening test. Foot Ankle Int. 2006, 27: 1103-1108.PubMed
40.
go back to reference Putti AB, Arnold GP, Cochrane L, Abboud RJ: The pedar® in-shoe system: repeatability and normal pressure values. Gait Posture. 2007, 25: 401-405.CrossRefPubMed Putti AB, Arnold GP, Cochrane L, Abboud RJ: The pedar® in-shoe system: repeatability and normal pressure values. Gait Posture. 2007, 25: 401-405.CrossRefPubMed
41.
go back to reference Menz HB, Morris ME: Footwear characteristics and foot problems in older people. Gerontology. 2005, 51: 346-351.CrossRefPubMed Menz HB, Morris ME: Footwear characteristics and foot problems in older people. Gerontology. 2005, 51: 346-351.CrossRefPubMed
42.
go back to reference Portney LG, Watkins MP: Foundations of clinical research: applications to practice. 2009, Upper Saddle River, N.J: Prentice Hall Health, 3 Portney LG, Watkins MP: Foundations of clinical research: applications to practice. 2009, Upper Saddle River, N.J: Prentice Hall Health, 3
43.
go back to reference Menz HB: Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine. Foot. 2004, 14: 2-5.CrossRef Menz HB: Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine. Foot. 2004, 14: 2-5.CrossRef
44.
go back to reference Butler DS: The Sensitive Nervous System. 2000, Adelaide: Noigroup Publications Butler DS: The Sensitive Nervous System. 2000, Adelaide: Noigroup Publications
45.
go back to reference Litcher-Kelly L, Martino SA, Broderick JE, Stone AA: A systematic review of measures used to assess chronic musculoskeletal pain in clinical and randomized controlled clinical trials. J Pain. 2007, 8: 906-913.CrossRefPubMedPubMedCentral Litcher-Kelly L, Martino SA, Broderick JE, Stone AA: A systematic review of measures used to assess chronic musculoskeletal pain in clinical and randomized controlled clinical trials. J Pain. 2007, 8: 906-913.CrossRefPubMedPubMedCentral
Metadata
Title
Correlates of foot pain severity in adults with hallux valgus: a cross-sectional study
Authors
Sheree E Hurn
Bill T Vicenzino
Michelle D Smith
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2014
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-7-32

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