What is Hallux Valgus?
Hallux valgus or its full name of hallux abducto valgus is more commonly known as a bunion. A bunion is often described as a visible bump on the side of the foot at the base of the big toe. The bump appears due to the altered position of the big toe, instead of pointing in the same direction as the rest of the toes the big toe, also referred to as the hallux, points across the foot towards the little toe.
The toes consist of 5 bones numbered in the sense that your big toe is 1st and your little toe is your 5th. The big toe is divided into two parts; there is a distal section (the section under your nail) and a proximal section (the section that connects to the metatarsals). The first joint is known as the metatarsal-phalangeal joint (the joint that connects the metatarsals to the phalanges), the last joint is the interphalangeal joint (ip joint) that connects the distal and proximal bones. The formation of the joints allows a wide range of movement in flexion and extension and also allows you to curl your toes.
Why and when does Hallux Valgus happen?
Bunions are a common foot deformity, and are most often the result of poor foot biomechanics or posture like flat feet or high arches. Altered function of the feet in these circumstances leads to increased pressure through certain parts of the foot including the big toe. Bunions tend to run in the family due to an increased likelihood of inheriting a foot type that is prone to developing the condition and not in fact that they are hereditary. Footwear is also an essential key to the development of a bunion, although it doesn’t directly cause a bunion. Any footwear that squeezes and is very tight over the toes (for instance very high and pointy high heels) contributes to the condition developing further and progressing at a faster rate.
What does Hallux Valgus feel like?
In the early stages of a bunion symptoms will be minimal with only a slight noticeable alteration in the position of your big toe. To start with the toe will slightly lean towards the other toes, progressively the lean will worsen to the point that in some cases the big toe starts to completely overlap the second toe. The progression is normally relatively slow and is over quite a few years. In the later stages the symptoms become more prominent and include a lot of pain and discomfort around the bump at the base of the big toe. There will be noticeable swelling and additional redness over the joint line. Occasionally there will be a mild burning sensation or numbness experienced over the joint line. These symptoms will be aggravated after long periods of walking or standing and after wearing tight and compact shoes, like high heels.
How is Hallux Valgus diagnosed?
Your GP or podiatrist/chiropodist should be able to fully diagnose you by listening to your symptom history and thoroughly examining the big toe. Your doctor will most likely order an X-ray of the foot to determine the extent of the joint deformity and to rule out any underlying arthritic joint conditions that may complicate treatment.
What treatment options are available for hallux valgus?
The treatment options for a bunion vary depending on how early the condition is diagnosed and the extent of the deformity. Bunions are progressive and don’t go away so in the early stages most doctors will recommend conservative treatment to ease pain levels and try to delay the need for surgical intervention in the future. Conservative treatment will not reverse the deformity. Treatment will include ensuring you are wearing the right kind of footwear with wide toes, avoiding those pointed high heels. Specialist padding and orthotics can minimise the discomfort and pressure over the bunion. The doctor will most likely prescribe anti-inflammatory medication and painkillers for pain relief and to reduce any swelling there is also the option of using ice packs on the area or corticosteroid injections to reduce persistent inflammation and pain.
Bunions progress and develop at different rates. Doctors will normally recommend surgical intervention in more severe, progressed cases or when conservative treatment fails. Surgery is aimed at reducing the pain levels by reducing the bump and straightening the toe alignment. You will be referred to a specialist ankle and foot orthopaedic surgeon who will recommend the type of surgery based on your health, activity level and the severity and extent of your condition. The recovery and results you see after surgery will vary, depending on the type of procedure performed.