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Bunions (Hallux Valgus)

A bunion is a deformity of the base joint of the big toe. The cause is not clear in many cases. The deformity may cause the foot to rub on shoes which may cause inflammation and pain. Good footwear is often all that is needed to ease symptoms. An operation to correct the deformity is an option if good footwear does not ease symptoms.

What is a bunion?

A bunion is when your big toe is angled towards the second toe. This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. Sometimes a fluid filled sac (bursa) develops over the joint.

What causes bunions?

Diagram of the foot showing a bunion (011.jpg)

The underlying cause is a deformity of the joint at the base of the big toe. The deformity is called 'hallux valgus'. In this deformity the joint develops a prominent sideways angle. Due to this deformity the bones of the big toe are pushed towards the smaller toes.

The skin over the angled joint then tends to rub on the inside of shoes. This may cause thickening and inflammation of the overlying skin and tissues next to the affected joint.

In most cases it is not clear why a hallux valgus deformity develops. There may be some genetic (hereditary) tendency to have a 'weakness' of this joint. In some cases it is associated with a joint problem such as osteoarthritis or rheumatoid arthritis.

However, whatever the underlying cause, wearing tight or badly fitting shoes tends to make symptoms worse. Wearing such shoes puts extra pressure on the big toe joint and causes friction on the overlying skin.

What symptoms and problems are caused by bunions?

  • Pain. You may then have difficulty walking due to pain.
  • Inflammation and swelling at the base of the toe. This sometimes becomes infected.
  • The foot may become so wide that it can be difficult to find wide enough shoes.

What is the treatment for bunions?

Good footwear is often all that is needed

Wearing good footwear does not cure the deformity but may ease symptoms of pain and discomfort. Ideally, get advice about footwear from a podiatrist or chiropodist. Advice may include:

  • Wear shoes, trainers or slippers that fit well and are roomy.
  • Don't wear high-heeled, pointed or tight shoes.
  • Padding over the bunion may help.

Medication

Painkillers such as paracetamol or ibuprofen may ease any pain. If the bunion develops as part of an arthritis then other medication may be advised. A course of antibiotics may be needed if the skin and tissues over the deformity become infected.

Surgery

An operation may be advised if a change of footwear does not ease symptoms. The aim of the operation is to straighten the joint as much as possible. There are many different types of operation which are used to treat bunions. These range from operations to 'trim' parts of the joint, to a total artificial replacement of the big toe joint (similar to a knee or a hip replacement). The operation chosen by the specialist depends on the severity of the bunion, the shape of your foot, and other factors such as if you have arthritis in the joint.

An operation is usually successful at easing symptoms, but not in all cases. Your specialist will be able to advise on the pros and cons of surgery, and the success rate of the chosen operation.

References

Comprehensive patient resources are available at www.patient.co.uk

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS and PiP have used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
© EMIS and PiP 2008    Updated: 19 Feb 2008   DocID: 4567   Version: 38
















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PS - Health and Poverty

Perhaps the biggest cause of ill health in the world is poverty. Help to Make Poverty History. For example, why not lend some of your money to disadvantaged communities to enable them to trade their way out of poverty through schemes such as Shared Interest.

See also MAKEPOVERTYHISTORY North East for details and links to campaigns against poverty.

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