Hallux Valgus / Varus

What is Hallux Valgus?

A bunion or hallux valgus is a large bump on the side of the foot that develops at the base of the big toe. The bunion may become inflamed and swollen, causing foot pain.

Causes

The common cause of bunion can be wearing narrow and tight shoes. But other than that, certain orthopaedic conditions can also cause a hallux valgus/bunion. Usually, people having inherited structural bone defects and suffering from arthritis can be struck by a bunion. Also, people who put extra stress on their feet can also be affected by the bunion.

Symptoms

The symptoms of a bunion can be seen gradually over time. The most prominent symptom of a bunion is the bulging of the bigger toe joint. This indicates that the person is affected by the bunion. Other than this, there are some common bunion symptoms that should be noted.

The symptoms are:

• Swelling and redness around the big toe joint
• Persistent and intermittent pain in foot toes
• Restricted movements
• Numbness in the foot
• Skin thickening on the base of the affected toe joint
• Hardened skin under the foot

Diagnosis

Physical examination:

The examiner asks for the medical history and symptoms. Observes the walking and weight-bearing pattern. The examiner also checks the foot and the big toe to observe any swelling, deformity, or tenderness. The strength of the foot and big toe, are measured to assess the flexibility and range of motion.

X-ray:

An X-ray is a diagnostic procedure that helps to identify the cause and severity of a bunion.

Treatments

Treatment options vary depending on the severity of your bunion and how much pain it causes.

Conservative treatment

Nonsurgical treatments that may relieve the pain and pressure of a bunion include:

• Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes.
• Padding. Over-the-counter, nonmedicated bunion pads or cushions may be helpful. They can act as a buffer between your foot and your shoe and ease your pain.
• Medications. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve) can help you control the pain of a bunion. Cortisone injections also might help.
• Shoe inserts. Padded shoe inserts can help distribute pressure evenly when you move your feet, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter supports can provide relief for some people; others require prescription orthotic devices.
• Applying ice. Icing your bunion after you’ve been on your feet too long or if it becomes inflamed can help relieve soreness and swelling. If you have reduced feeling or circulation problems with your feet, check with your doctor first before applying ice.

Surgical options

If conservative treatment doesn’t relieve your symptoms, you might need surgery. Surgery is not recommended for cosmetic reasons; only when a bunion causes you frequent pain or interferes with your daily activities.

There are many surgical procedures for bunions, and no one technique is best for every problem.

Surgical procedures for bunions can be done as single procedures or in combination. They might involve:

• Removing the swollen tissue from around your big toe joint
• Straightening your big toe by removing part of the bone
• Realigning one or more bones in the forefoot to a more normal position to correct the abnormal angle in your big toe joint
• Joining the bones of your affected joint permanently