Bunions (Hallux Valgus) are characterised as the big toe joint protruding to the side, with the effect of making the toes appear push together.
What are Bunions?
The word Hallux is the medical term for the big toe, or great toe. Valgus means the toe is twisted slightly, so the big toe no longer rests completely on the toe pulp.
Therefore Hallux Valgus, or bunion, is a deformity at the first metatarsal-phalangeal joint of the foot.
Are bunions hereditary?
There is evidence to suggest it is hereditary. Badly fitting shoes do not cause bunions, but can exacerbate the condition (barefoot tribe members can develop bunions!).
There are stages of bunion development which catalogue the extent of the deformity, from a small ‘bump’ to gross deformity where the big toe lies beneath the second toe.
How does it affect me?
The first metatarsal-phalangeal joint becomes inflamed and painful. Swelling and redness builds up at the side of the joint, and on the top. A protective sac of fluid (bursa) builds up and makes the whole area very tender. This can often cause problems in shoe fitting.
As the deformity worsens, the bony changes enlarge the joint which impairs function and causes more pain and discomfort. Some patients have deformity with little or no pain. Others suffer a great deal.
What can I do about it?
Treatments for bunions can be divided into two : conservative and surgical.
Footwear is an important component of successful therapy. In many cases, a change in footwear can provide relief from the discomfort of bunions. Insoles can help by combating the mechanical stresses made upon the joint, and improving function. Padding and strapping can help, but only in the short term.
Podiatric surgeons and orthopaedic surgeons can operate on bunions to reduce the deformity. Many departments now perform this range of procedures under local anaesthetic, so a bunion operation is very often a day surgery case.