Oh, the ever popular bunion. A bunion is a condition known to the medical community as hallux valgus. The hallux is the medical term for the big toe, and valgus is an angled alignment. Thus, hallux valgus describes a big toe that angles toward the other toes.
A bunion involves a hard callus that forms on the edge of the big toe where it rubs the inside of a shoe. This underlying callus and the hardened tissue can be very painful. The joint at the base of the big toe also goes through changes that can lead to osteoarthritis due to the abnormal forces placed there during walking.
This condition can be troublesome and may worsen due to certain footwear, certain walking patterns, and other weight-bearing activities. It is important to catch these early to prevent further irritation and joint injury.
Several factors are at play in the formation of a bunion including heredity, weakness (particularly in the hip and buttock muscles), and a key cause, footwear. Narrow shoes such as high heels and cowboy boots cram the toes into a small space, putting extra pressure on the inside edge of the big toe.
What to do? Usually the first step (no pun intended) is to address footwear. A wide shoe that supports the arch of the foot is vital. Second, it’s important to check for changes in walking pattern and for weakness in the hip and leg. Third, foot strength and mobility should be considered. Sometimes, shoe inserts, orthotics, or toe spacers can be used to reduce pain and improve foot and toe alignment. Physical therapy can help with each of these needs.
Surgery is sometimes required depending on severity of the condition. Surgical options include a bunionectomy, which involves removing the callused bone. Other surgical options include osteotomy where the big toe is realigned and pinned so the toe is straight and the foot is balanced.
For more information about bunions, click here for our educational document on this topic.