Hallux Valgus (Bunion)

About

A hallux valugs deformity occurs when the big toe deviates towardsthe second toe, rather than pointing straight – producing the bunion’s “bump”. Bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. As the bunion progresses, the big toe joint fails to function properly leading to arthritis in the joint. Osteoarthritis can develop in the big toe joint as the bunion worsens over time, causing increased pain and stiffness in the joint.

Causes

Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is
not the bunion itself that is inherited, but certain foot types that make a person prone to
developing a bunion. Although wearing shoes that crowd the toes won’t actually cause
bunions, it sometimes makes the deformity get progressively worse. Some other common causes
include type of footwear (i.e. high heels and tight fitting footwear), poor foot mechanics,
and/or trauma.

Symptoms

• Bump of the side of the big toe joint
• Inflammation and redness
• Corns or callus (hard skin) around the area

• Pain and soreness
• Burning sensation or numbness
• Stiffness moving the joint

Diagnosis

Bunions are most readily apparent – the prominence is visible at the base of the big toe or
side of the foot. However, to fully evaluate the condition, our podiatrist may take x-rays
to determine the degree of the deformity and assess the changes that have occurred.

A comprehensive assessment and biomechanical assessment may also be performed to identify
any biomechanical factors contributing to the deformity.

Treatment

The following treatment options are offered for bunions;

• Nonsteroidal anti-inflammatory medications (NSAIDs) and Ice – help reduce the pain and inflammation
• Padding and strapping the foot
• Prescription of custom made orthotics – orthotics are designed to guide the
  posture/mechanics of the foot and reduce pressure at the big toe joint
• Footwear recommendations – advice regarding comfortable and supportive shoes
• Injection therapy – prolotherapy can be used to reduce symptoms
• Activity modifications
• Splinting the big toe joint

Because bunions are progressive and there is no effective treatment to get rid of them,
surgery is sometimes indicated.