Bunion (Hallux Valgus)
Also known as: Hallux valgus, Bunion, Bunion deformity, Great toe bunion, Big toe bunion, First metatarsophalangeal (1st MTP) joint bunion, Hallux valgus deformity
Last updated: December 18, 2024
A bunion (hallux valgus) is a progressive deformity of the joint at the base of the big toe. The big toe angles toward the smaller toes, and a bony bump forms on the inner side of the foot. It may cause pain or tenderness, especially with pressure from shoes, along with difficulty with footwear and functional limits. Wider shoes with a roomy toe box may be used, and it often worsens slowly over time.
Key Facts
- •A bunion, medically known as hallux valgus, is a progressive deformity of the first metatarsophalangeal joint in which the big toe deviates toward the smaller toes while a bony prominence develops on the inner side of the foot
- •Visible bump on the inside of the foot at the base of the big toe
- •Diagnosed through history, physical exam, and imaging
- •First-line treatment includes exercise, weight management, and activity modification
What It Is
A bunion, medically known as hallux valgus, is a progressive deformity of the first metatarsophalangeal joint in which the big toe deviates toward the smaller toes while a bony prominence develops on the inner side of the foot. The condition can cause pain, difficulty with footwear, and functional limitations, and may worsen over time without intervention.
Affected Anatomy
This condition affects several structures in and around the joint:
- •First metatarsophalangeal (MTP) joint
- •First metatarsal head (forms the bony bump)
- •Proximal phalanx of the great toe
- •Medial collateral ligament of the first MTP joint
- •Sesamoid bones under the first metatarsal head
- •Surrounding bursa and soft tissues
Common Symptoms
Symptoms can vary in intensity and may change over time. Common experiences include:
- •Visible bump on the inside of the foot at the base of the big toe
- •Big toe pointing toward the smaller toes
- •Pain or tenderness over the bunion, especially with pressure from shoes
- •Redness, swelling, or inflammation around the joint
- •Calluses or corns where toes overlap or rub
- •Difficulty finding comfortable shoes
- •Decreased motion or stiffness of the big toe
- •Pain with walking or other weight-bearing activities
Causes and Risk Factors
Multiple factors can contribute to the development of this condition:
Causes
- •Inherited foot structure and mechanics that predispose to the deformity
- •Abnormal foot mechanics including overpronation
- •Ligamentous laxity allowing joint instability
- •Progressive imbalance of forces across the first MTP joint
- •Footwear that crowds the toes (narrow, pointed shoes) may accelerate progression but is not a primary cause
Risk Factors
- •Family history of bunions
- •Female sex (more common in women)
- •Wearing narrow, pointed, or high-heeled shoes
- •Rheumatoid arthritis or other inflammatory joint conditions
- •Flat feet or low arches
- •Hypermobility or ligamentous laxity
- •Neuromuscular conditions affecting the foot
- •Older age (progression over time)
How It's Diagnosed
Diagnosis typically involves a combination of clinical assessment and imaging studies:
- •Visual inspection of the foot showing characteristic deformity
- •Medical history focusing on symptoms, footwear, and family history
- •Physical examination assessing range of motion, tenderness, and alignment
- •Weight-bearing X-rays to measure angles and assess joint condition
- •Hallux valgus angle and intermetatarsal angle measurements
- •Assessment for arthritis or sesamoid displacement
- •Evaluation of overall foot alignment and mechanics
Treatment Options
Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:
Self-Care and Activity Modification
- •Wider, more accommodating footwear with adequate toe box
- •Padding or cushioning over the bunion
- •Custom or over-the-counter orthotic inserts
- •Toe spacers or splints (may provide comfort but do not correct deformity)
- •Ice application for symptom relief
- •Activity modification to reduce aggravating activities
Medications
- •NSAIDs for pain and inflammation
Surgery
- •Bunionectomy (surgical correction) may be considered for persistent pain and functional limitation
Prognosis and Recovery
The course of this condition varies between individuals:
- •Bunions typically progress slowly over time without treatment
- •Conservative measures can provide symptom relief but do not reverse the deformity
- •Surgical correction generally provides good pain relief and improved function
- •Recurrence after surgery is possible, particularly without addressing underlying mechanics
- •Early intervention may prevent severe deformity and secondary problems
Related Pages
- Bunionectomy (Bunion Surgery)(Procedure)