Bunions (hallux valgus)

A bunion is a sore bump which develops on the joint connecting the big toe to the foot. It can be part of a condition called hallux valgus. Hallux refers to the big toe and valgus means pointing towards the outside of the foot. A bunion or hallux valgus is when the big toe joint becomes bent towards the little toes. The bump is usually caused by the metatarsal bone rubbing on the inside of shoes, causing pain and inflammation.

Other problems can develop along with bunions: the metatarsal bones can become more prominent in the ball of the foot and the small toe joints can become bent, causing a condition known as hammer toes. Shoe pressure can also cause corns and calluses to develop.

How is it caused?

Although there is sometimes no obvious cause, bunions may be caused by tight fitting shoes and high heels, where the feet are squashed. Other factors that may affect your likelihood of having a bunion include: a family history of the condition; flat feet; muscular imbalance conditions such as polio or cerebral palsy; rheumatoid arthritis or osteoarthritis.

What are the symptoms?

The main symptoms are pain and inflammation around the bunion, making shoes uncomfortable and walking or other activities difficult.

Can it become worse?

People often put up with the symptoms for many years before seeking medical help and the problem becomes slowly worse as the big toe is pushed further towards the small toes, often causing the second toe to bend upwards as the big toe pushes beneath it. Eventually this can lead to big toe arthritis. Although the condition can be treated at any stage, if arthritis has developed in the big toe joint, then surgery to simply realign (straighten) the toe may not work and other options such as toe fusion surgery may need to be considered.

How is it diagnosed?

A medical examination to discuss your symptoms is usually backed up by X-rays to diagnose the problem.

How is it treated?

• Non-operative treatment: this aims to relieve the symptoms by reducing pressure on the painful area when you are active. It may involve:o    Toe spacers or re-alignment splints
  • Padded insoles, advice on shoes or custom-made shoes
  • Painkillers or anti-inflammatory medication (if recommend by your doctor)
• Bunion surgery: this is the only method of physically changing the shape of your foot. It realigns your toe to correct the bunion deformity and will narrow the profile of your foot to allow you to resume your active lifestyle and wear the type of shoes you want. If big toe arthritis develops in the big toe joint then surgery to realign the toe may not work and other options such as toe fusion surgery or big toe joint replacement surgery may need to be discussed.

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please call us for advice if you’re worried about any aspect of your health or recovery.