Hallux Abducto Valgus (HAV), commonly known as bunions, are a common deformity of the joint in the big toe that can lead to displacement and lateral deviation, resulting in a bony exostosis or “bunion bump”. This bunion bump can also occur on the little toe and is referred to as a Tailor’s Bunion.
This displacement and deformity of the big toe can lead to outward deviation of the other toes and commonly clawing or retraction of the second toe. It is aggravated by ill-fitting footwear causing irritation, inflammation and possible bursa (fluid filled sac between the tendon and bone). These joint alignment changes can contribute to uncomfortable corns and callouses growing due to the toes being squeezed together.
Bunions usually develop slowly, and many people have them for years with no problems at all. However, some people find the skin covering the bunion can get red and inflamed or callused, or the bunion can make wearing shoes and walking difficult and painful.
Causes of a Bunion:
- Hereditary
- Abnormal walking style and altered biomechanics of the foot (excessive pronation or flat feet)
- Ill-fitting narrow, pointed footwear or long term wearing of high heels
- Trauma
The 4 Stages and Symptoms of a Bunion:
- First Stage: deformity only visible on X-ray, minimal discomfort or pain, tightening of the tendon on the inside of the big toe.
- Second Stage: visible lateral displacement of the big toe towards the second toe, slight bump evident, forefoot becomes wider with mild to moderate pain and inflammation.
- Third Stage: increased widening of the forefoot, increased space between the big toe and second toe, increased tenderness and deformity.
- Fourth Stage: total dislocation of the big toe joint, deformity and enlarged bunion bump, possible clawed second toe.
The goal is to try and stabilise the bunion in Stage 2 for as long as possible. This is because stage 3 is where most of the deformity occurs and increase in the size of the “bunion bump”.
Bunion Treatments:
- Supportive footwear
- Toe separators
- Foot orthoses to offload pressure in that area
- Foot mobilisation therapy
- Night splint
- Daily stretching and strengthening exercises for the big toe
- Anti-inflammatory medication for pain
- Orthopaedic review/ surgical correction
This can be a painful and embarrassing foot condition for many people. For the best results it is important to seek treatment in the initial stages of the condition. Our Podiatrist can help with your bunion pain and provide you with a treatment plan to increase comfort and slow down the progression of joint deformity and displacement.