Bunion (Hallux Valgus)
A Bunion is generally considered as an enlargement of the joint at the base and side of the big toe. Bunions are a progressive disorder, beginning with a leaning of the big toe towards the others, gradually changing the angle of the bone and production of a characteristic prominent bump. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of that joint. Bunions can become painful, and in many cases arthritis and stiffness can eventually develop.
Bunions start as the big toe begins to turn and develop a firm bump on the inside edge of the foot, at the base of the big toe. Initially, the Bunion may not be painful but as the toe deviates more there may be pain near the joint with redness and swelling.
The pain is most commonly due to two things – it can be from the pressure of the footwear on the Bunion or it can be due to arthritis like pain from the pressure inside the joint. The motion of the joint may be restricted or painful.
Bunions occur at a joint where the big toe bends during normal walking and can therefore be extremely painful. They are vulnerable to excess pressure which can lead to the development of a hammer toe of the second toe, corns, calluses and the change in pressure may predispose it to an ingrown nail.
The initial goal of treatment is simple - to relieve pressure on the bunion and to halt or slow the progression of the joint deformity. There are a number of things that our Podiatrists and Chartered Physiotherapists can do to help manage symptoms and improve range of motion.
- Addressing of any footwear issues
- Correction of the imbalance within the foot using an orthotic device
- Strengthening of the lower limb to control foot motion
Unfortunately, In some cases this isn’t enough to elevate symptoms and a surgical referral is required.
Our Chartered Physiotherapists can assess your feet using a Gait scan to determine where the instability lies. Orthotics will play a role in slowing progression and in the prevention of bunions developing again post-surgery. Our highly skilled Physiotherapists will also provide a personalised fitting service of your custom orthotics.
The most common cause of Hallux valgus and bunions is instability in the front part of the foot. There is a large hereditary connection with foot type explaining why
Bunions are passed down through the family. Tight fitting footwear will aggravate a Bunion and accentuate the problem but are not the only cause. Bunions are mostly a result of an imbalance in the forces that are exerted across the joint during walking, which leads to instability in the joint. Bunions can also follow foot injuries and develop in those with neuromuscular problems.
Those with flat feet or pronated feet appear to be more prone to the instability in the joint and have a higher incidence of bunions. Such faulty foot mechanics can be assessed and treated by our Podiatrists or one of our highly skilled Chartered Physiotherapists.