Hallux Abducto Valgus (HAV), commonly known as bunions, are a deformity of the joint in the big toe that can lead to displacement and lateral deviation, referred to as the “bunion bump”. Although not as common, this can also happen to the little toe and is referred to as a Tailor’s Bunion.
This displacement and deformity of the big toe can lead to outward deviation of the other toes and commonly clawing of the second toe. It is aggravated by ill-fitting footwear causing irritation, inflammation and possible bursa (fluid filled sac between the tendon and bone).
Cause of Bunions:
- Abnormal walking style and altered biomechanics of the foot (excessive rolling in or flat feet).
- Ill fitting narrow footwear.
The 4 stages and Symptoms of Bunions:
- Stage 1: deformity only visible on X-ray, minimal discomfort or pain, tightening of the tendon on the inside of the big toe.
- Stage 2: visible lateral displacement of the big toe towards the second toe, slight bump evident, forefoot becomes wider with mild to moderate pain and inflammation.
- Stage 3: increased widening of the forefoot, increased space between the big toe and second toe, increased tenderness and deformity.
- Stage 4: total dislocation of the big toe joint, gross deformity and enlarged bunion bump, possible clawed second toe.
The goal is to try and stabilise the bunion in Stage 2 for as long as possible. This is because rapid deformity and increase in the size of the “bunion bump” occur most in Stage 3, due to forces on the bunion as the big toe pushes off the ground in a deviated position.
Treatment for Bunions:
- Supportive footwear
- Toe separators
- Foot orthoses to off load pressure in that area
- Foot mobilisation therapy and or dry needling
- Daily stretching and strengthening exercises for the big toe
- Anti-inflammatory medication for pain
- Orthopaedic review/ surgical correction
Bunions can be a painful and embarrassing foot condition for many people. For the best results it is important to seek treatment in the initial stages of the condition. Well Heeled Podiatry can help with your bunion pain and embarrassment and provide you with suitable footwear options and foot orthoses to increase comfort and slow down the progression of joint deformity and displacement.