BUNION (HALLUX ABDUCTO VALGUS)

What is a bunion?

While a bunion is typically described as a bump on the side of the big toe, it is actually a change in the bony structure of the foot. As seen in the picture above, the bones are led out of alignment as the big toe leans toward the second toe, rather than pointing straight ahead. The misalignment causes the “bump”.

Bunions are slow growing. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the “bump”. Symptoms usually appear at later stages, although some people may never have symptoms.

Causes
Most bunions are caused by an inherited predisposition to bunions (i.e, one’s inherited mechanical structure). Other times, certain foot types can make a person prone to developing bunions instead.

Wearing narrow shoes won’t actually cause bunions, but it sometimes makes the deformity get progressively worse and symptoms may appear sooner.

Symptoms

Inflammation and redness

Pain or soreness

A burning sensation

Possible numbness

Diagnosis
The bony prominence (the “bump”) is visible at the base of the big toe or side of the foot. However, for a proper diagnosis, Weight Bearing foot x-rays are necessary to determine the degree of the deformity.

Conservative Treatment

·   Changing your shoes. Choose shoes that have a wide-toe box.

·   Getting bunion pads. Pads placed over the area of the bunion can help minimize pain. 

·   Modifying your activity. Avoid activity that causes bunion pain, including standing for long periods of time. 

·   Taking medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

·    Icing. Applying an ice pack several times a day helps reduce inflammation and pain.

·   Injection therapy. injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.

·   Using orthotic devices. It will keep your foot in the best anatomical position. 

When Is Surgery Needed?
Discussing surgical options with your provider to decide if surgery is best for you would take place when conservative, non-surgical treatments do not relieve bunion pain and when the pain interferes with daily activities.

A variety of surgical procedures are available to treat bunions. The objectives of surgery are the reduction of pain and correction of the deformity.

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the bony prominence. Symptoms usually appear at later stages, although some people may never have symptoms.