BUNION (Hallux Valgus)*

BUNION (Hallux Valgus)*

CONDITION: BUNION

A bunion is a bony bump that forms at the base of your big toe. Bunions develop on the inside edge of your big toe joint — the metatarsophalangeal (MTP) joint. The MTP joint is where the base of your big toe meets your foot. The medical term for bunions is hallux valgus.

SYMPTOMS

  • Visible Bump: A protruding bone or swollen area on the side of the big toe joint.

  • Pain or Tenderness: Aching or throbbing pain around the bunion, especially with pressure from footwear.

  • Swelling and Redness: Inflammation around the joint, which may feel warm to the touch.

  • Restricted Movement: Stiffness in the big toe, leading to difficulty bending or moving it.

  • Calluses or Corns: Thickened skin where the big toe overlaps with adjacent toes or rubs against shoes.

  • Foot Fatigue: Generalized aching or discomfort in the foot, particularly after standing or walking for long periods.

CAUSES & RISK FACTORS

  1. Genetics:

    • A family history of bunions increases the likelihood of developing them, as inherited foot shapes and mechanics can contribute.

  2. Footwear:

    • Tight, narrow, or high-heeled shoes that squeeze the toes can worsen or trigger bunions.

  3. Foot Structure:

    • Flat feet, overly flexible ligaments, or abnormal bone structures may predispose individuals to bunions.

  4. Arthritis:

    • Inflammatory conditions like rheumatoid arthritis can damage joints and lead to bunion formation.

  5. Occupation or Lifestyle:

    • Activities requiring prolonged standing or wearing restrictive shoes (e.g., ballet, certain professions) can increase risk.

DIAGNOSIS & TESTS

  1. Physical Examination:

    • A healthcare provider will inspect the foot, assess the alignment of the toes, and evaluate symptoms like pain and swelling.

  2. Imaging:

    • X-rays are commonly used to determine the severity of the deformity and assess joint damage.

  3. Patient History:

    • Discussion of symptoms, family history, lifestyle, and footwear choices.

MANAGEMENT & TREATMENT

  1. Conservative Treatments:

    Conservative treatment of a bunion may include shoe modification, padding, orthotics with the goal of stabilizing the deformity. This helps provide non-surgical relief for those who are not surgical candidates.

    • Footwear:

      • Wear shoes with a wide toe box and adequate support to reduce pressure on the bunion.

    • Padding and Taping:

      • Use bunion pads or tape to protect the area and help maintain alignment.

    • Orthotics:

      • Custom insoles can help redistribute pressure and correct foot mechanics.

    • Medications:

      • Over-the-counter pain relievers like ibuprofen can reduce pain and inflammation.

    • Ice Therapy:

      • Apply ice packs 15 mins/hr to the area to alleviate swelling and discomfort.

2. Surgical Intervention:

  • When Needed:

    • Surgery is considered for severe cases that cause chronic pain or significant functional impairment.

  • Types of Procedures:

    • Minimally Invasive Surgical Correction

      You may qualify for a minimally invasive correction which allows for faster healing with less pain, scarring, and down time.

    • Stabilizing Midfoot Correction: AKA "Lapidus" Correction

      Depending on your foot type, you may benefit most from a stabilizing procedure to reduce bunion pain. Call to further discuss which option may be right for you!

    • Arthrodesis: Fuses the joint to correct alignment.

    • Bunionectomy: Removes the bony bump and realigns the bones.

    • Osteotomy: Cuts and reshapes the bones of the toe.

PREVENTION

  • Proper Footwear:

    • Choose shoes with ample room for the toes, good arch support, and cushioning.

  • Avoid High Heels:

    • Limit the use of heels higher than 2 inches.

  • Maintain a Healthy Weight:

    • Reducing pressure on the feet can help prevent bunions.

  • Strengthening Exercises:

    • Toe stretches and foot exercises can improve muscle balance and joint function.

  • Early Intervention:

    • Address minor toe misalignments or discomfort promptly to prevent worsening.

PROGNOSIS

  • Proper Footwear:

    • Choose shoes with ample room for the toes, good arch support, and cushioning.

  • Avoid High Heels:

    • Limit the use of heels higher than 2 inches.

  • Maintain a Healthy Weight:

    • Reducing pressure on the feet can help prevent bunions.

  • Strengthening Exercises:

    • Toe stretches and foot exercises can improve muscle balance and joint function.

  • Early Intervention:

    • Address minor toe misalignments or discomfort promptly to prevent worsening.