Impact of Pain in Other Body Regions on the Foot-Specific Quality of Life in Patients with Hallux Valgus

CATEGORY: Bunion INTRODUCTION/PURPOSE: The purpose of this study was to clarify the prevalence of pain outside the foot, and to determine the associations of pain outside the foot with foot-specific quality of life (QOL) in patients with hallux valgus. METHODS: Patients scheduled to undergo surgery for idiopathic hallux valgus (rheumatoid forefoot deformity not included) were recruited. Patients less than 20 years old, and those with a history of foot and ankle surgery were excluded. Patients answered whether they experienced disabling pain in 13 body regions other than the foot. Foot-specific QOL was assessed using the Self- Administered Foot Evaluation questionnaire (SAFE-Q). Foot pain was quantified using the visual analogue scale (VAS). Patient characteristics, including age, sex, comorbidity, anxiety, and depression, were also surveyed. The association between pain elsewhere and the SAFE-Q and pain VAS scores were assessed using univariate and multivariate analyses. RESULTS: Of 102 patients, 55 (54%) experienced pain other than the foot. All SAFE-Q subscale scores were lower, and pain VAS was higher in patients with pain elsewhere than in patients without. In the multivariate analysis, an increase in the number of pain regions was independently associated with a decrease in SAFE-Q scores and an increase in pain VAS. CONCLUSION: More than half of the patients with hallux valgus experienced pain elsewhere. The presence of pain elsewhere was associated with poorer foot-specific QOL and severer foot pain. Assessment of pain elsewhere is necessary to evaluate foot- specific QOL in HV patients.