What is a Bunion (Hallux Abducto Valgus) and How Can it be Treated?

hallux valgus

bunionsA bunion, also known as a hallux valgus deformity or hallux abducto valgus deformity, is characterized by a deviation of the first metatarsal and hallux. The first metatarsal of course is the thin bone running to the big toe, whereas the hallux is the big toe itself. It is often believed to be an enlargement of the bone or tissue, whereas in fact this is not the cause of the hallux valgus deformity.

The actual cause of bunions however is a cause for debate. Some professionals believe that they are caused by the long-term use of ill-fitting shoes, usually those with narrow, pointed feet. Others claim that bunions are the result of genetic factors. It may also be a combination of both – that a genetic predetermination is then exacerbated by shoe use.

Either way, bunions tend to be caused when pressure is applied to the side of the big toe for a long amount of time, causing it to point inwards towards the other toes.

Symptoms of Hallux Valgus Deformity

The best way to imagine a hallux valgus deformity is to imagine the big toe pointing at an angle outwardly then and pushing against your second toe. In extreme cases, this might cause the toe to sit on top or underneath the others.

At the same time, this will occur alongside a bulge underneath the big does along the first metatarsal on the outside of the foot. The bump is partly caused by a swollen bursal sac as well as the head of the first metatarsal bump that is now pushing outwards.

Bunions can also cause a number of unwanted effects. These include redness and soreness of the skin where the side of the foot may be rubbing against the inside of the shoe and where the metatarsal may be rubbing on the inside of the foot. This can also cause swelling and pain that worsens during pressure. Often it will be necessary to buy larger shoes to accommodate the change of foot shape. Where the toe overlaps the other toes, this can then cause other problems as those toes are now also pushed into the wrong position.

Causes of Bunions

As mentioned, bunions are generally thought to be the result of the ongoing use of tight fitting shoes. This can be confirmed by research showing that cultures that don’t wear shoes, never get bunions. Again though, there are also thought to be genetic elements at play and in particular different placement of the tendons, ligaments and metatarsals can lead to bunions developing later in life. Here, the bio-mechanical anomaly may also be the result of other problems – such as flat feet or excessive flexibility. This can then lead to a vulnerability that causes bunions to form when pressure is applied.

Hallux Valgus Deformity Treatment

If you have a bunion on your foot, then there are a few things you can do to help solve the problem. One basic solution to begin with is to switch to larger and more spacious shoes. Using orthotics such as gelled toe spaces, bunion splints and bunion cushions can all also help. These provide extra support and structure to help encourage the toes back into their correct position. Custom orthotics can be prescribed or you can also get more general purpose over-the-counter products.

Another option is surgery. Surgical procedures for bunions include removal of the abnormal bony enlargement of the metatarsal, realigning the metatarsal to align parallel with the others, shortening, lengthening, raising or lowering the first metatarsal bone and even joining the metatarsals.

Generally, bunion surgery is performed under local or general anesthetic. It is a relatively safe and routine procedure but can require 6-8 weeks for full recovery and mobility. As usual however, surgery will normally be considered as a last resort and rather orthotics and lifestyle adjustments will be preferred.

Prevention

If you want to prevent a hallux valgus deformity, then make sure to avoid wearing tight fitting shoes. When you’re at home, keep your feet free. You can even consider using ‘toe yoga’ which is designed to help improve the flexibility of the toes. Or why not try your hand (or foot) at a little barefoot running?

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