Related Experiment Video
Updated: Nov 11, 2025
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta-Analysis
Sheree E Hurn1, Barry G Matthews2, Shannon E Munteanu3
1Queensland University of Technology, Brisbane, Queensland, Australia.
Insights
Nonsurgical treatments for hallux valgus (HV) show limited evidence of effectiveness. While some interventions may reduce foot pain, improvements in the hallux valgus angle are less certain.
Area of Science:
- Orthopedics
- Physical Therapy
- Evidence-Based Medicine
Background:
- Hallux valgus (HV) is a common foot deformity.
- Nonsurgical interventions are frequently employed to manage HV symptoms.
- Evidence regarding the efficacy of these treatments requires systematic evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of nonsurgical interventions for hallux valgus.
- To assess the impact of various conservative treatments on foot pain and the hallux valgus angle.
Main Methods:
- A comprehensive literature search was conducted across Medline, CINAHL, Embase, and the Cochrane Library up to April 2020.
- Included studies were parallel-group and crossover designs evaluating nonsurgical HV interventions.
- Risk of bias was assessed using the Cochrane risk-of-bias tool (version 2), and Grading of Recommendations, Assessment, Development, and Evaluation methodology was applied.
Main Results:
- Eighteen studies investigated diverse nonsurgical interventions for hallux valgus, often with small sample sizes and high risk of bias.
- Meta-analyses of foot orthoses, splints, manual therapy, and taping combined with exercises showed no significant effect on primary outcomes.
- Significant pain reduction was observed with foot orthoses, night splints, dynamic splints, manual therapy, taping with exercises, physical therapy programs, and Botox injections.
- Clinically significant reduction in the hallux valgus angle was reported for night splints, foot exercises, physical therapy, and Botox injections.
Conclusions:
- The certainty of evidence for nonsurgical hallux valgus interventions is low.
- Pain reduction appears to be a more achievable outcome than correction of the hallux valgus angle.
- Further high-quality research is needed to establish definitive treatment guidelines.
Objective:
To conduct a systematic review and meta-analysis investigating the effectiveness of nonsurgical interventions for hallux valgus (HV).
Methods:
Medline, CINAHL, Embase, and the Cochrane Library were searched to April 2020, including parallel-group and crossover studies investigating nonsurgical interventions for HV. Two reviewers independently screened articles for inclusion, extracted data, determined risk of bias, and made assessments using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. Risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool. Effect sizes (mean differences or risk ratios, and 95% confidence intervals) were calculated and pooled where possible for the primary outcomes, foot pain, and HV angle.
Results:
Eighteen included studies investigated a wide range of nonsurgical interventions for HV. Most studies had small sample sizes and concerns regarding risk of bias. Five separate meta-analyses for foot orthoses, splints, manual therapy, and taping added to foot exercises showed no significant effects on primary outcomes. However, results from 8 studies showed a significant pain reduction with the use of foot orthoses, night splints, dynamic splints, manual therapy, taping added to foot exercises, a multifaceted physical therapy program, and Botox injections. Four studies reported a clinically significant reduction in HV angle with night splints, foot exercises, multifaceted physical therapy, and Botox injections.
Conclusion:
There is a low level of certainty surrounding the effectiveness of nonsurgical interventions for HV, but a reduction in pain appears more likely than improvement in HV angle.
