How to Treat and Relieve a Bunion (Hallux Valgus)?

What is a Bunion (Hallux Valgus)?

A bunion is a painful bony bump that develops on the inside of the foot at the joint of the big toe. Bunions are often called "hallux valgus".

Bunions develop slowly. Pressure on the big toe joint causes the big toe to bend toward the second toe. Over time, the normal bone structure changes, resulting in the bunion bump. This deformity gradually worsens and can cause pain when wearing shoes or walking.

Anyone can develop a bunion, but it's more common in women. Many women wear narrow, tight shoes that compress the toes, making it easier for bunions to develop, worsen, and cause painful symptoms.

In most cases, bunion pain is relieved by wearing wider shoes that provide ample toe space and other simple hallux valgus treatments aimed at reducing pressure on the big toe.

What are the causes of Hallux Valgus?

Early hallux valgus: One of the factors associated with the appearance of bunions is the inheritance of bone structure. While this deformity is not an inherited defect in itself, the fact is that it is favored by the type of gait, which depends on the body morphology, which is inherited by genes. Therefore, it is not the bunion that is inherited but the type of foot.

There are other factors that increase the risk of bunion formation:

• Faulty structures, such as flat feet. Not all people with flat feet have bunions, but there are structural and mechanical reasons why bunions develop more easily when the foot functions in a certain way;
• Excessively loose ligaments. Joints depend on ligaments for their structural stability. When ligaments are loose, it's easy to see how weight-bearing joints, such as those in the feet, lose some structural support;
• Congenital anomalies such as metatarsus adductus;
• Arthritis. Diseases such as rheumatoid arthritis can destabilize joints and accelerate their degeneration;
• As mentioned above, high heels or narrow shoes are also considered to promote bunion growth because they tend to push the big toe towards the other toes. They can worsen existing bunions or cause them to appear in people with a genetic risk. Poor foot mechanics, combined with other risk factors, increases the chances of developing bunions;

What is the progression of Hallux Valgus?

When you have a bunion, you may have simple symptoms such as:

• Pain or discomfort in the big toe joint;
• Swelling of the big toe joint;
• Difficulty finding shoes that fit;

But these symptoms can worsen to become:

• Difficulty walking and running;
• Pain under the forefoot (because the other toes have to support a greater proportion of the body weight when walking or running);
• Red, blistered, or infected skin on the bunion;

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What are the complications of Hallux Valgus?

The doctor specializing in hallux valgus is a podiatrist or orthopedist. If you experience the following symptoms, you should consult one of them.

• Intense pain in the big toe and at rest of the foot;
• Difficulty moving the toe or toes;
• Difficulty finding suitable shoes, as they are all uncomfortable;

This problem is permanent and in some cases, it is complicated and requires surgery to correct.

These cases are as follows:

• Hammer toe: this is the inflamed joint of the toe next to the big toe, which causes pain and pressure;
• Bursitis: the cushions that cushion the foot become inflamed and fill with fluid. This inflames the bones and tendons;
• Metatarsalgia: disorder of the metatarsal joints;

Can a Bunion (Hallux Valgus) be Corrected?

The following measures can help relieve bunion symptoms:

• Hallux valgus shoes: Suitable hallux valgus shoes;
• Hallux valgus orthosis: Hallux valgus orthosis (special insoles worn in shoes), they can be prescribed by your doctor or podiatrist;
• Over-the-counter pain relievers and anti-inflammatories, such as paracetamol or ibuprofen (always read the leaflet that comes with the medicine);
• Using a cold pack, such as ice or a bag of frozen peas, wrapped in a towel, until the swelling subsides can help;

However, if the bunion is causing significant pain or discomfort, you may need surgery to correct it. The goal of surgery is to straighten the big toe joint as much as possible and reduce pain and discomfort.

What solutions to limit the progression of Hallux Valgus and relieve pain?

Wear comfortable and suitable shoes

• Ask your doctor, podiatrist, or sports physiotherapist to recommend suitable running shoes;
• Avoid wearing shoes that are too tight: you should be able to wiggle your toes a little and there should be 1 cm between the longest toe and the end of the shoe;

Reduce compression and friction on the foot

• Ask your doctor, podiatrist or physiotherapist to recommend hallux valgus exercises to relieve symptoms and slow the progression of the bunion;
• Avoid continuing to run if the bunion causes pain or discomfort: make an appointment with your family doctor or a sports doctor;

When should surgery be considered?

Hallux valgus: when to operate? Hallux valgus when to operate if there is hallux valgus pain or deformation compromising other toes, due to the consequences of hallux valgus surgery. After hallux valgus surgery, the walking pattern changes and overloads areas of the foot that did not receive these loads before the hallux valgus surgery, which can cause pain. Despite this, many cases of hallux valgus require surgery, it must be taken into account that if it is necessary, it should not be postponed because hallux valgus pain cannot be avoided in any other way.

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