Hallux valgus (bunion): the key elements

Hallux valgus, often referred to as a bunion, is a common foot condition where the big toe (hallux) gradually deviates towards the smaller toes. This deviation causes a bony lump to form on the side of the foot, near the base of the big toe. While it is not typically a dangerous condition, it can lead to discomfort, pain, and difficulty in finding well-fitting footwear.

We speak to a consultant orthopaedic surgeon who explains the key elements of this condition.

What are the causes?

There is no single cause for hallux valgus, but several factors can contribute to its development. Genetics plays a significant role, as the shape and structure of your foot, such as flat feet or overly flexible joints, may predispose you to this condition.

Wearing poorly fitting shoes, particularly high heels or narrow-toed footwear, can exacerbate the problem by putting undue pressure on the front of the foot. Certain medical conditions, such as arthritis, can also make a person more prone to developing hallux valgus.

What are the symptoms?

The most noticeable sign of hallux valgus is the protruding bump on the side of the foot. Other symptoms may include redness, swelling, or tenderness around the affected joint. Over time, the big toe may become stiff, making it harder to move, and corns or calluses can develop due to friction from tight shoes.

Pain is a common complaint, especially when walking or wearing certain types of footwear. In severe cases, the misalignment can also affect the balance and function of the other toes.

How is it diagnosed?

Diagnosis of hallux valgus usually involves a physical examination of the foot. Your doctor may ask about your symptoms, family history, and footwear habits. X-rays are often taken to determine the severity of the condition and assess whether there are any underlying issues with the bones or joints.

How can it be treated?

Treatment for hallux valgus depends on the severity of the symptoms and the impact on your daily life. Non-surgical options are often the first step. These may include:

• Footwear modifications: Choosing shoes with a wide toe box and good arch support can relieve pressure on the affected area.
• Padding and orthotics: Cushions or custom shoe inserts can help reduce discomfort and redistribute weight.
• Exercises and physiotherapy: Certain exercises may improve foot strength and flexibility, potentially slowing the progression of the deformity.
• Pain relief: Over-the-counter painkillers, such as ibuprofen, can help manage inflammation and discomfort.

When should you see a doctor?

If hallux valgus causes persistent pain, difficulty walking, or affects your quality of life, it’s essential to consult an orthopaedic surgeon. Early intervention can help manage symptoms and prevent the condition from worsening over time.