Bunions (Hallux Valgus)


A bunion is a deformity of the base joint of the big toe. The cause is not clear in many cases. The deformity may cause the foot to rub on shoes which may cause inflammation and pain. Good footwear is often all that is needed to ease symptoms. An operation to correct the deformity is an option if good footwear does not ease symptoms.
A bunion is when your big toe is angled towards the second toe. This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint.

What causes bunions?

The underlying cause is a deformity of the joint at the base of the big toe. The deformity is called hallux valgus. In this deformity the joint develops a prominent sideways angle. Due to this deformity the bones of the big toe are pushed towards the smaller toes.

The skin over the angled joint then tends to rub on the inside of shoes.

In some cases it is associated with a joint problem such as osteoarthritis or rheumatoid arthritis.

However, whatever the underlying cause, wearing tight or badly fitting shoes tends to make the problem worse.

What symptoms and problems are caused by bunions?

  • Pain.
  • Inflammation and swelling at the base of the toe.
  • The foot may become so wide that it can be difficult to find wide enough shoes.
  • You may get arthritis in the big toe.
  • The second toe can become deformed.
  • In severe cases, the big toe can push your second toe up out of place.

What is the treatment for bunions?

Good footwear is often all that is needed. Wear shoes, trainers or slippers that fit well and are roomy. Don't wear high-heeled, pointed or tight shoes. Padding over the bunion may help as well as ice packs.

Painkillers such as paracetamol or ibuprofen may ease any pain. A course of antibiotics may be needed if the skin and tissues over the deformity become infected.

An operation may be advised if a change of footwear does not ease symptoms. The aim of the operation is to straighten the joint as much as possible and relieve pain. These range from operations to trim parts of the joint, to a total artificial replacement of the big toe joint (similar to a knee or a hip replacement). The operation chosen by the specialist depends on the severity of the bunion, the shape of your foot, and other factors, such as if you have arthritis in the joint.

You will need to continue to wear sensible, wide-fitting shoes for six months after the operation.

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