What is a Bunion?
Hallux valgus is a complex deformity of the bones and soft tissues of the first ray (big toe and 1st metatarsal) which results is the characteristic prominence referred to as a bunion. The deformity may not be limited to the big toe. Often one or more of the lesser toes are involved and may be more painful than the big toe. Claw toes are often associated with a bunion. There are many risk factors for bunions but 70% of people have a family history. Spurs from arthritis (hallux rigidus) are often mistaken for a bunion.
What are the Symptoms?
Bunions are often painless. People with symptoms may experience discomfort in shoes, either over the bunion or one of the lesser toes. Discomfort under the ball of the foot may occur when the big toe is no longer doing it’s job and the weight is shifted to the bone of the second toe (transfer metatarsalgia). This is felt especially in bare feet.
What is the Treatment?
A bunion which is asymptomatic requires no treatment. If you are offered surgery for cosmesis you should seek a second opinion. Once symptoms occur, whether in the bunion itself or the lesser toes, non-surgical treatment consists of comfortable footwear, toe spacers or pads. Podiatry for orthotics can be helpful in those with flat feet or transfer metatarsalgia (see above).
Failing non-surgical treatment, operative correction by an orthopaedic surgeon can be considered. Bunion surgery is tailored to your specific condition, the severity, and the toes involved. A combination of bony and soft tissue procedures is often required.