Bunions (Hallux valgus)

What is bunion?

Hallux valgus, often referred to as "a bunion," is tilting over towards the smaller toes and a bony lump appears on the inside of the foot. Sometimes a soft swelling develops over the bony lump.

Are bunions hereditary?

Bunions can run in families. It is more common in people with flexible joints, and this can be hereditary. They are also commoner in women than in men.

What is the effect of shoes?

Bunions can occur, but much less commonly in culture that do not wear shoes. Narrow shoes that squeeze the big toe or high heels may worsen the deformity, particularly in people who are at higher risk.

Why it gets painful?

The main problem is usually pain because of the pressure of the shoe over the bony prominence. The skin over the bunion can become red, blistered or infected. The foot gets broader that makes it difficult to get shoes.

The big toe can push the second toe out of place so it presses on the shoe. The big toe does not work as well with a bunion, and the other toes have to take more of the weight of the body as you walk. This can cause pain under the ball of the foot ("metatarsalgia").

Long standing deformity can lead to arthritis of the joint, causing pain in the joint.

What is the non-surgical treatment?

Many people with bunions are quite comfortable if they wear wide, well-fitting shoes. A small soft bunion pad over the bony prominence can absorb the pressure off the bunion. High heels should be avoided whenever possible.

Can an operation cure a bunion?

An operation can correct the deformity of the big toe and narrow the foot back towards a more desirable shape.

There are a lot of different operations for bunions. The orthopaedic surgeon who specialises in foot & ankle surgery can advise you on the best operation for your foot.

What are the complications of bunion surgery?

Studies show that 85% of people who have bunion corrections are satisfied with the results. However, a number of problems can arise:

The big toe can be slightly stiffer than before. For most people this does not matter, but for athletes or dancers it can be important.

In a small number of people the deformity can recur and occasionally this is bad enough to need to have the operation redone. On the other hand, over correction rarely occur.

Infections in the wound and minor damage to the nerves of the toe can also occur.

This may sound like a lot of possible problems, but in fact most people do not get them and are satisfied with their bunion surgery. However, this may help you to see how important it is to have any bunion surgery carried out by a properly trained and experienced foot and ankle surgeon.