Hallux Valgus (Bunions)
What is hallux valgus?
Hallux valgus (also known as bunion) is a bony bump on the inside of the foot at the base of the big toe with the big toe tilting towards the second toe.
Many people who have bunions do not get any real problems with their feet and nothing needs to be done. Some people will however get pain around the big toe or problems with their shoes.
The bump can make foot wider and it can be difficult to find shoes which are comfortable
The bump can rub on shoes and become red and swollen and in some cases the skin can blister.
Some people with bunions go on to have problems with their smaller toes too.
What causes hallux valgus?
Inherited factors and the shape of the bones in feet can cause bunions. Footwear which does not fit well probably has a role in making bunions more uncomfortable and increasing problems in the future.
What tests may be done?
You do not need any x-rays or special tests to diagnose bunions, these are only used for planning surgery.
What can you do to help your bunion?
There are many non-surgical treatments that can help.
Footwear: One of the most important things you can do to help is to wear the right footwear. You should try to wear wide shoes with a low heel that fit you comfortably. Shoes with laces or an adjustable strap are best as they can be adjusted to the width of your foot.
Do not wear high heeled, pointed or tight shoes as this will make your pain worse.
Diet: Losing weight will reduce the strain on your feet.
Medication: Painkillers such as paracetamol can reduce the pain. Follow the advice from your community pharmacist or other healthcare professional about taking medication. It is important to take medication regularly.
Exercise: helps build the strength of the small muscles in your feet, which can take the strain off the toes and we think help to delay or stop problems getting worse.
What else can be done?
Most patients with bunions respond well to non-surgical treatments, especially changing their footwear. Where these have been tried and failed then there may be other options. If your pain does not start improving after a period of 3 months of following the advice above, please get referred to your local Podiatry Department to see a healthcare professional who can assess your foot.
Some patients may be referred on for Orthopaedic footwear or a surgical opinion.
Surgery is considered in patients who have significant problems with their bunions and have tried non-surgical management which has not worked usually over at least 12 months.
An operation will not give you an entirely normal foot, but it will correct the shape of the big toe and narrow your foot back towards a more usual shape.
The aim of bunion surgery is to straighten the big toe and make it more comfortable. There are several procedures for bunion surgery and the best surgery for you depends on the size of your foot.
For most people the surgery is a bony surgery where the bones of your toe are cut and reset to straighten your big toe. This is called an osteotomy, some people who have developed arthritis in their big toe joint need a different type of operation where the big toe joint is surgically stiffened (fused). Very occasionally if your foot is more complicated an operation would be done further back in the middle of your foot to help straighten and support it.
Bunion surgery is largely very successful with around 85% of people happy with the outcome but as with any operation there are some risks.
After foot surgery, it may take 3-6 months for you to be back to your normal level of activity where you will be able to work standing all day, however every person is different.
The videos below show exercises that may be useful in strengthening the muscle to help it cope better with the demand that you are placing on it.
Don’t expect things to improve overnight though. It takes time for muscles and joints to adapt and get stronger.
To find out more about Hallux Valgus (Bunions), including information about exercises, visit our webpage.