Bunion (Hallux Valgus)

23
Sep
  • Bunions (Hallux Valgus)
  • Bunions (Hallux Valgus)
Bunions (Hallux Valgus)
  • Stuart
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  • Big toe joint pain . bunion . footwear issues . hallux valgus .

A bunion, known medically as ‘Hallux Valgus’ is an abnormal alignment of the big toe. The first metatarsal begins to drift towards the other foot whilst the big toe deviates towards the smaller toes.

Bunions  or hallux valgus are a common condition seen within clinic.  Patients describe pain and discomfort from the bump or within the big toe joint or both.

Footwear typically presses on the bony bump causing irritation.  So recall increases symptoms in the pushing off phase of walking.

Over time a bursa can form which is a fluid-filled sac over the joint. Callus and corn formation can occur as pressure on the surrounding skin.

The Prognosis is uncertain. Some patients experience the progression of deformity and symptoms rapidly, others remain asymptomatic. 

One study found that hallux valgus is often unilateral(one foot) initially but usually progresses to bilateral deformity.

 

Hallux valgus: The Facts

90% of patients with a bunion can recall a family member also having a bunion.

38% of females and 21% of males are estimated to have bunions.

30years of age is the most common age of onset.

Bunions are found in the non-shoe wearing Tribal populations.

Hallux valgus can occur at any age, even in children with 2% of children aged 9 to 10 years show signs, but are more commonly seen in those above 30years of age.

It is commonly seen in clinic an estimated 38% of females and 21% of males over the age of 30 years have hallux valgus, this is taken from random population studies.  The incidence also increases with age (Nix et al 2010).

Genetics play a major role with 90% of patients with hallux valgus can recall a family member also having a bunion. (Vidal et al 2007).

Causes of Hallux Valgus

1.Footwear

It is generally accepted that high heeled shoes with a narrow toe box do not cause the onset of the bunion, but increase the symptoms, as cause rubbing and irritation of the skin of the bump over the big toe joint and pushing on the big toe.

2.Mechanics

This is considered to be one of the most common factors, a flat foot can lead to instability of the joint at the base of the 1st long metatarsal bone.  This combined with increased movement and mobility within the joint can cause a change in position to improve stability within the bones at the front of the foot.

 

3. Metabolic
Conditions such as  Rheumatoid Arthritis are often associated hallux valgus.

4. Trauma
This is the least common cause, but  non-united fractures, dislocations, and severe soft-tissue sprains around the first MTP joint can lead to the onset of hallux valgus.

Treatment options:

Conservative...

These do not reduce the bunion deformity, but more importantly may assist with pain relief, options Include:

Footwear A good fitting shoes to accommodate the bump, making sure footwear is wide and long enough with enough depth in the toe box, avoiding shoes with a narrow toe box.

Orthotics/insoles can provide some pain relief, and are considered to most beneficial in the early stages.

Padding and silicone covers, such as these from Simply feet

Surgical Treatment...

There are over 100 different procedures that have been listed for correction of hallux valgus deformities.

This can vary on the size of the bunion, age of the patient, movement within the foot and quality of bone.

A blog on hallux valgus correction will be coming soon!

If you would like further information please see below or to find a Podiatrist in your area, here is a link for the College of Podiatry.

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