Bunions(Abducto Valgus)

Definition

Bunion is the misalignment of the big toe joint (Hallux Abducto Valgus) or the first metatarsophalangeal joint. It is a progressive bony degeneration.

Symptoms

The big toe joint protrudes outwards making the forefoot wider. The joint may become red, inflamed and painful with restrictive footwear. Pain will be relieved once shoes are taken off. Patients may also get inflammation of the bursa which is adjacent to the big toe joint leading to bursitis.

Causes

• Tight restrictive footwear with high heels can increase the risk of developing a bunion
• Genetic predisposition (especially in younger cases)
• Poor biomechanics (flat feet) accompanied with poor selection of shoes
• Patients with Rheumatoid arthritis

Who can get bunions?

• People who wear tight/constrictive footwear with high heels
• Ballet dancers
• People with a family history of bunions are more susceptible
• Bunions are more common in women than in men

Risks

If bunions are not attended to in a timely manner, the following may occur which may lead to further complications.

• Clawing of lesser toes (to hold on to the ground) as the big toe deviates and loses its functionality
• Breakdown of skin at the big toe joint which may lead to an infection
• Formation of corns and calluses in areas of high friction and pressure (such as little toes and big toe joint)
• Big toe (hallux) over-riding the lesser toes
• Widening of the forefoot
• Difficulty in finding appropriate footwear due to the widening of the forefoot

Prevention

• Wear wide supportive shoes
• Avoid tight narrow fitting shoes. Wearing tight narrow fitting shoes can accelerate the process of bunion formation. It is almost impossible to prevent a bunion as it is a progressive bony degeneration. Wearing supportive shoes with orthotics (inner soles) may slow down bunion growth

Treatment

• Wear wide supportive shoes for walking
• Use custom made inner soles (orthotics) inside footwear to support the arch and the big toe joint
• Ice the big toe joint with a cold pack
• Rest
• Taking anti-inflammatory medication to reduce inflammation and pain

If conservative measures are not helping and the joint is still very painful, surgery may be suggested to correct the alignment of the big toe joint. This surgical procedure is called bunionectomy.