UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Age Factors; Aged; Aged, 80 and over; Body Mass Index; Cohort Studies; Educational Status; Female; Flatfoot; Hallux Valgus; Humans; Male; Risk Factors; Shoes


Epidemiology | Geriatrics | Musculoskeletal Diseases


OBJECTIVE: To examine potential risk factors for hallux valgus in community-dwelling elders.

METHOD: Data from 600 MOBILIZE Boston Study participants (386 women and 214 men) were analyzed. Hallux valgus was defined as >15 degrees angular deviation of the hallux with respect to the first metatarsal bone toward the lesser toes. Associations of hallux valgus with age, body mass index (BMI), race, education, pes planus, foot pain, and in women, history of high heel shoe use, were assessed using sex-specific Poisson regression with robust variance estimation for risk ratios (RR) and 95% confidence intervals (CI).

RESULTS: Hallux valgus was present in 58% of women and 25% of men. Higher BMI was inversely associated with presence of hallux valgus in women (P trend=0.001), with the strongest inverse association observed in those with BMI of 30.0 or more compared to those with normal BMI (RR=0.7, 95% CI: 0.5, 0.9). Women, who usually wore high-heeled shoes during ages 20-64 years compared to those who did not, had increased likelihood of hallux valgus (RR=1.2, 95% CI: 1.0, 1.5). Among men, those with BMI between 25.0 and 29.9 had increased likelihood of hallux valgus compared to those with normal BMI (RR=1.9, 95% CI: 1.0, 3.5). Men with pes planus were more likely to have hallux valgus (RR=2.1, 95% CI: 1.3, 3.3) compared to men without pes planus.

CONCLUSION: In women, hallux valgus was associated with lower BMI and high heel use during ages 20-64, while in men, associations were observed with higher BMI and pes planus. Our results suggest that the etiologic mechanisms for hallux valgus may differ between men and women. Elsevier Ltd. All rights reserved.


Hallux valgus, Pes planus, Foot pain, BMI, High-heeled shoes, Population-based cohort study

Rights and Permissions

Open Access funded by OsteoArthritis Society International. Under an Elsevier user license.

DOI of Published Version



Nguyen US, 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 Jan;18(1):41-6. doi:0.1016/j.joca.2009.07.008. Link to article on publisher's site

Journal/Book/Conference Title

Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society

Related Resources

Link to Article in PubMed

PubMed ID