Hallux Valgus (Bunion)

Hallux valgus, commonly called bunions, is a bony protrusion at the joint of the big toe where it bends inward. This condition often appears on both feet and largely affects women over the age of 40. Here’s how to recognize hallux valgus and solutions for treating it.

 

Hallux valgus: How to recognize it

Hallux valgus can be identified with the naked eye. It creates a bony deformity at the front of the foot. Red skin can also be seen around the big toe joint. The area may feel hot to the touch and may even be tender.

This deformity can become uncomfortable, especially when wearing certain types of stiffer shoes. Basic physical activities like walking can aggravate it, as the big toe plays an important role in moving the body forward.

Juvenile hallux valgus

There are essentially two main forms of hallux valgus, with the so-called juvenile form accounting for about 30% of cases. The second form represents the remaining 70% of cases and is related to aging or certain physiological conditions.

Juvenile hallux valgus is caused by a defective orientation of the metatarsal head. It occurs fairly early, usually when someone is in their twenties, and is hereditary.

Causes

A number of factors other than heredity can contribute to the development of hallux valgus. These causes are physiological, health related or tied to certain habits, such as wearing shoes with high heels, pointed toes or narrower shapes.

For women, menopause is also considered an aggravating factor of this morphological condition. The presence of osteoarthritis may also accentuate the development of hallux valgus.

Other physical conditions can also be a factor, such as flat foot, pronation or excessive weight gain. People with a rheumatological disease, arthritis or polio are also more likely to develop hallux valgus.

Symptoms

The main symptom of hallux valgus is aesthetic: the first metatarsal moves towards the inside of the foot and causes the first joint of the big toe to protrude. The big toe undergoes a pronounced and abnormal deviation towards the second toe. This results in a hard bump on the inner side of the foot that is commonly referred to as a bunion.

Hallux valgus may be more or less pronounced depending on the angle of the big toe. Mild hallux valgus is a minor deviation of the toe, with the joint remaining functional. Hallux valgus is considered severe when the deviation is greater than 40 degrees. It can even force the big toe over or under the second toe. When that happens, the big toe joint usually stops working.

Solutions and treatment of hallux valgus

If left untreated, hallux valgus can become painful and can even interfere with walking. There are various solutions to treat this condition.

 

Foot orthotics

You can wear a foot orthotic that has a metatarsal dome. It supports the transverse arch of the foot and alleviates pressure on the big toe. It helps reduce pain. Orthotics worn during walking also reduce the load and help control pronation of the foot.

Shoes

Specially designed orthopedic shoes follow the anatomy of the foot while limiting the curvature of the big toe and reducing pressure on the forefoot. Shoes with thick, rocker-type soles and a heel less than an inch high are recommended.

Toe seperators

Toe separators are removable orthotics custom designed by an orthotist. Their role is to compensate for the deficient function of one or more toes. They are an ideal treatment for severe hallux valgus. These orthotics fit between the big toe and the second toe and help realign the joint. They also reduce friction between the toes and eliminate much of the discomfort caused by hallux valgus.

Surgery

Surgery to permanently treat hallux valgus may be considered if the deformity is too severe or the pain is intense and no form of treatment is sufficient. Surgery corrects the deviation of the big toe to keep the joint working properly. It can also help stop the development of arthritis.