Bunion- Hallux valgus

Hallux valgus, commonly referred to as “a bunion,” is a deformity of the big toe. The toe tilts over towards the smaller toes and a bony lump appears on the inside of the foot. (A bony lump on the top of the big toe joint is usually due to a different condition, called hallux rigidus.) Sometimes a soft fluid swelling develops over the bony lump. The bony lump is the end of the “knuckle-bone” of the big toe (the first metatarsal bone) which becomes exposed as the toe tilts out of place. This condition is progressive and may require, conservative treatment or surgical intervention in extreme cases.

What causes a ‘bunion’?

A bunion is the result of a deformity in the joint of your big toe. The exact cause isn’t clear, it is thought to be a combination of factors such as:


  • Genetic factor
  • Abnormal foot function and mechanics of the foot (pronation)
  • Anatomical structure of the 1stjoint
  • Footwear
  • Arthritis


How do I best prevent a bunion?

Supportive footwear

If you’re wearing flat shoes, like ballet-pumps, and your feet pronate (roll in when you walk), it will make your condition worse.

Look for footwear with a molded foot-bed inside the shoe, preferably with a low heel. You also need plenty of toe room, so choose shoes with rounded toes. Some women buy shoes that are a size too small, because they are so used to their toes touching the sides of the shoes. You should be able to wiggle your toes comfortably. Go to a good shoe shop if you’re unsure and they will size your feet for you.

The other feature you should look for are shoes that have laces or a Velcro strap across the instep, to stop your foot sliding forward. If you buy a slip-on, even though they may be fairly flat, you’ll be sliding forward with every step you take. This will mean that the joints and toes will experience gentle trauma, which can exacerbate the problem over a long time.

Getting good trainers and sandals can also be a wise choice. You should choose a trainer that’s designed to help a foot perform well in sport. These will help to support your foot and give good shock absorption.

How does orthotics help?

Orthotics are usually placed just behind the big toe joint on the bottom of the foot. They can take pressure off the big toe and help redistribute the body weight while people walk.

Foot orthosis can correct dysfunctional biomechanics and therefore reduce pain, provide support and better positioning, prevent the development of foot deformity, improve the overall biomechanical function of the foot.

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