Bunion / Hallux valgus - Causes, symptoms, Treatement
Bunion, also called hallux valgus is a foot injury that is related to the stance of the big toe and affects the joint on the base of the big toe. It mainly occurrs with women, men don't seem to suffer from it as much. Also some people are genetically more prone to acquiring the disorder, causing generation after generation with the problem.
Instead of growing forwards, the big toe grows slightly inward, towards the othger toes. As a consequence the joint at the base grows outward, causing the bunion.
This bunion can be very painful, as the foot does not fit in the shoes nicely anymore. The bunion moves against the shoe constantly. This causes pain, skin-irritation, sometimes even open wonds and also inflammtion in the joint. In even more severe cases, the big toe grows inward so far that also the second toe is affected, causing a hammer toe.
Because the big toe plays such a major role in walking, muscles, tendons and joints can weaken or become instable, causing further foot problems.
Some people actually have a bunion, but as long as it is not painful, they do not suffer from it, and treatment is unnecessary.
Causes for bunions
For reasons that are not clear women suffer more from bunions then men. Also genetical factor play a role.
Another main cause is wearing incorrect shoes. Strangely enough in tradional societies where people still do not wera shoes, the condition does not occurr at all. Wearing correct shoes can be beneficial in preventing or treating hallux valgus, see the related article. If needed, visit a specialized foot store, or even go to a podiatrist.
Other causes for bunions are weakness in the joints, tendon disorders and incorrect stance of the feet.
With hallux valgus the big toe stands incorrect as compared to the other toes, causing a bunion on the inner side of the foot. This causes pain in the joint, on the outside of the foot. The skin is often red and swollen there as well.
Also skin irrriation often occurrs, sometimes even open wonds. Finally, also the bursa in the joint can become inflamed, causing even further irritation.
If the symptoms are less visible, an x-ray may be needed.
Treatment is not allways necessary. If there is a bunion visible, but there are no further complaints, no treatment is necessary. In earlier days sometimes preventive surgery was applied, but this is not advised anymore.
In early stages good shoes can cause the bunion to heel or prevent it from getting worse. Sometimes orthotics are used to correct the stance of the big toe. It may be advisable to consult a podotherapist before using these.
Tape or medical tape (kinesio tape) are sometimes used to correct the stance of the big toe.
If the problems persist, surgery of the bunion needs to be considered. This is being done quite regularly. Goal of the operation is to correct the incorrect stance of the big toe, and put it straight. This is being done by sawing throught the meta-tarsal bone and putting it straight. A temporary screw in the bone may be necessary temporarily. Soemtimes the joint is even fixed in a permanent position (arthrodesis).
In earlier days, complications after operations like these were quite frequent, but nowadays this is much less so. Still, there is always such a risk. Current ratio of patients with side-effects is around 10%.
Six weeks after the operation the foot-correction should be healed and the tissues regrown. In the mean time, rest should be taken.
There is alays a chance that the bunion may return, so it is necessary to keep taking pre-cautions like good shoes, etc.
Othyer treatments sometimes applied are the following:
- Podotheurapetic inlay soles.
- Silicon orthotics or night splints to keep the toes in a correct position. An example is the Valguloc.
It depends per treatment and per patient how long it takes before the complaints go away. This can be anything from days to months.