A hallux valgus deformity, commonly called a bunion is the commonest forefoot deformity. It causes symptoms on the medial edge of the foot, the sole, and the small toes. The condition can lead to painful motion of the joint and shoe wear difficulty.
Hallux valgus causes pain particularly in the bunion on the inner side of the foot, on loading under the foot and in the smaller toes.
Hallux valgus causes symptoms in three particular ways. First and foremost is pain in the bunion, the pressure-sensitive prominence on the medial side of the head of the first metatarsal. It hurts to wear a shoe. Furthermore, the valgus deviation of the great toe often results in a lack of space for the other toes. They become displaced, usually upwards, leading to pressure against the shoe. This is termed hammer toe or claw toe. Finally, normal function of the forefoot relies heavily on the great toe pressing down on the ground during gait.
A hereditary factor or predisposition is not preventable but other things are. For example, wearing shoes that fit properly (not too tight) and avoiding high heels can be important factors in preventing hallux valgus.
Non-operative treatment may alleviate symptoms but does not correct the deformity of the big toe. Surgery is indicated if the pain persists. The correct operation must be selected from a wide variety of available techniques. The first treatment option is non-operative care:
• Adjustment of footwear to help in eliminating friction at the level of the medial eminence (bunion) e.g., patients should be provided of a shoe with a wider and deeper toe box
• The condition of pes planus may be helped by an orthosis. Severe pes planus can lead to a recurrence of hallux valgus following surgery.
• Achilles tendon contracture may require stretching or even lengthening • This type of treatment can be applied in the early stage when the secondary contractures of the soft tissues and the alterations of the articular surfaces have not become permanent.
Surgery may be considered if your symptoms are severe and don't respond to non-surgical treatments. The type of surgery will depend on the level of deformity, the severity of your symptoms, your age, and any other associated medical conditions.