Characteristics associated with hallux valgus in a population-based foot study of older adults

Abstract

Objective: Hallux valgus (HV) is common in older adults, but limited studies of risk factors have reported conflicting results. This cross-sectional analysis examined the association of HV with foot pain and other characteristics in older adults.

Methods: The population-based Framingham Foot Study assessed HV, foot pain, foot structure (planus, rectus, and cavus), current and past high-heeled shoe use, age, and body mass index (BMI). Sex-specific logistic and multinomial logistic regression examined the association of HV and HV with pain with study variables.

Results: Of 1,352 men and 1,725 women (mean ± SD age 66 ± 10.5 years), 22% of men and 44% of women had HV, and 3% of men and 11% of women had HV with pain. Foot pain increased the odds of HV in both sexes (P < 0.05). In women, older age and past high-heeled shoe use increased the odds of HV by 27% and 47%, respectively (P < 0.01), and cavus foot structure decreased the odds of HV by 26% (P = 0.02). BMI >30 kg/m(2) decreased the odds of HV by 33% in men and 45% in women (P < 0.05). In women only, odds of pain and HV versus no pain and no HV were greater with older age and planus foot structure.

Conclusion: Our work showed different associations in participants who had HV with pain compared to those without foot pain. In both men and women, strong associations were observed between HV and foot pain and inversely with BMI. Older age was associated with HV in women only, as were protective associations with cavus foot structure.

Figure 1

An example of a plantar pressure scan with the divisions of the foot used to calculate the modified arch index as B/(A+B+C). (Note: Figure previously published by Riskowski JL, et al. Associations of Foot Posture and Function to Lower Extremity Pain: The Framingham Foot Study. Arthritis Care Res (Hoboken). 2013 Jun 5. doi: 10.1002/acr.22049. – Use with permission)