The aim of this advice is to give you some understanding of the problems you have with your big toe and to provide some advice on how to manage this. It is not a substitute for professional healthcare advice and should be used along with information you may be given by your GP or Allied health professional.
What is Hallux Valgus or a bunion?
A bunion is a deformity of the base joint of the big toe. The joint at the base of the toe develops a sideways angle. The deformity is called Hallux Valgus. Due to this deformity the bones of the big toe are pushed towards the smaller toes. The skin over the bunion can rub on the inside of your shoes. This may cause thickening and inflammation of the skin and tissues over the big toe joint. The thickened skin may become inflamed, swollen and painful. Sometimes a fluid filled sac (bursa) develops over the joint.
What causes a bunion?
In most cases it is not clear why a hallux valgus deformity develops. There may be some genetic (hereditary) tendency to have a weaknes of this joint. In some cases it can be due to a joint problem such as osteoarthritis or rheumatoid arthritis. Wearing tight or badly fitting shoes tends to make the problem worse. Wearing such shoes puts extra pressure on the big toe joint and causes friction on the overlying skin.
What are the Symptoms?
- Pain and stiffness of the big toe joint
- Swelling of the big toe joint
- Difficulty walking
- The foot may become so wide it can be difficult
to find wide enough shoes
- Arthritis in the big toe
How can it be Treated?
One of the most important things you can do to help is to wear the right footwear. You should try to wear flat wide shoes that fit you properly. Ones with laces or an adjustable strap are best as they can adjust to the width of your foot. You may also want to use a bunion pad over your bunion to give you come protection from the pressure of your shoes. You can usually buy these pads from a pharmacy or from you chiropodist or podiatrist. Do not wear high-heeled, pointed or tight shoes.
If other treatments do not help and your bunion is very painful you may be referred to an orthopaedic or podiatric surgeon for
assessment. An operation will not return your foot to normal but most people find that surgery reduces their symptoms and improves the shape of their foot.
Many people use medication to help them remain active and to cope with their pain and symptoms. It is recommended that you take your medication regularly. It is best to get advice from a GP or pharmacist.
There are other health interventions which may be more appropriate for your condition. These can be discussed with your health care practitioner.
It is usually recommended that you try to stay at work or get back to work as soon as possible. You do not need to be fully pain and symptom free to return to work. Research shows the longer you are off work the less likely it is that you return.
Investigations/do I need any special tests
The main way we diagnose your hallux valgus is through what you tell us and by examining your big toe. Other investigations may be considered, these can be discussed with your health care professional.
Try to stay positive. There is a lot you can do to help yourself. Most symptoms do settle with time.