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Hallux Valgus (Bunion)

Otherwise known as a bunion, Hallux Valgus (or Hallux Abducto Valgus) is a condition where the 1st metatarsal (foot bone) moves towards the middle of your body, and then the big toe is pulled towards your other toes. It can cause joint pain as well as causing discomfort with footwear. 

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A lady's feet which each have moderate bunions.

About Hallux Valgus

Hallux valgus, otherwise known as a bunion, is a condition which typically has a genetic basis and is then aggravated by lifestyle choices. 

This basically means that if you were born with the genetics to 'give' you a bunion, then it is likely that it will develop at some point in your life. This may occur sooner, or progress more quickly, if you wear certain types of shoes or engage in certain activities.

Hallux Valgus can cause issues in a number of ways:

  • Finding footwear that fits

  • Rubbing in footwear

  • Occupational hazards due to not finding footwear that fits

  • Pain while walking/running

  • Damage to other joints

  • Causing toe deformities

Grading Hallux Valgus

Medicine and healthcare like to give 'grades' to everything, and there are lots of different ways of measuring the severity of Hallux Valgus. In both the clinical and radiographic settings, the grades tend to have four levels, summarised by your favourite podiatrist as:

  1. Well-aligned big toe

  2. Slightly wonky big toe

  3. Pretty wonky big toe

  4. Super wonky big toe.

It's important to remember that the grading systems don't  mention anything about pain or function; so just because you scored highly, it doesn't mean you should let the position of your big toe limit you from doing things. 

A sitting person flexing their right big toe joint.
A woman holding her right foot with both hands, with the area over the first metatarsophalangeal joint reddened (with photoshop) to show the area of pain.

What else could it be?

Hallux Valgus is a genetic, progressive condition that affects the alignment of the big toe joint and, excluding turf toe (plantar plate injury to the big toe) injuries, there are not really any organic reasons for the big toe joint to deviate in that way. However, hallux valgus can co-exist or be confused with other conditions, such as:

  • Hallux Limitus

  • Hallux Rigidus

  • Hallux Varus

  • Turf Toe (plantar plate rupture of big toe joint) 

How is Hallux Valgus diagnosed?

Clinical examination and the history you give is often adequate: ultimately, your big toe is pointing in the wrong direction. However, imaging may be used to

  • Confirm the diagnosis

  • Identify how severe the problem is

  • Rule out other problems.

  • Give consideration to types of surgery that might be helpful

  • Create a record of the severity of the condition

Imaging that can be used for hallux valgus:

  • X-rays are used for grading and give a good overview of the joint's integrity

  • Ultrasound scans can be useful for confirming osteophyte presence and identifying any co-existing soft tissue pathology like bursas

  • MRIs may be useful if the cartilage is damaged and causing catching.

An X-ray of a left foot with a moderate hallux valgus deformity and sesamoid shift.
A barefoot person standing with their big toes pointing skywards.

How is Hallux Valgus treated?

Treatments can take a variety of formats, each with different goals. The main goals I see in patients attending podiatry appointments for hallux valgus are:

  • Improving the appearance

  • Preventing it getting worse

  • Reducing pain

  • Reducing co-existing symptoms. 

Treatments include:

  • Education & understanding the condition

  • Painkillers - including when and how to use them

  • Footwear advice

  • General footcare & chiropody

  • Insoles and orthotics

  • Taping, strapping and padding

  • Injections:

    • Steroids​

    • Hyaluronic acid​​

  • Surgery​​​

How long does it take to cure Hallux Valgus?

Hallux Valgus is a structural condition, so in order to cure it's appearance, you would require surgery, and so you can expect anything from two weeks (for minor procedures) to 8-12 weeks for the more significant reconstructive procedures. 

If pain is your issue, then it depends on what aspect of the hallux valgus deformity is causing your pain, but the majority of musculoskeletal issues can be resolved within 6-8 weeks. 

If the pain you're experiencing is due to issues with friction, calluses or corns, then these can be resolved within minutes by some good quality footcare. With a bit of work on your part, these can also be prevented from coming back. 

Lady running with her dog
Ready to say goodbye to your pain?

At Keep On Your Feet, we openly acknowledge that we cannot guarantee a cure for things: but we will work as hard as we can with you to help you reach your goals. 

If your symptoms fit the above, you will need to book a 'Foot Pain' consultation. This will be £95 and lasts approximately 60 minutes usually. If you need insoles, we'll give you some basic ones to try out (or some fancier ones and reduce their price!). 

However, if your symptoms are related to corns, calluses, or other skin issues due to the bunions, then you may benefit from a 40 minute 'Regular Podiatry' consultation at £55.

This is a picture of Jeremy Ousey, director and podiatrist of Keep On Your Feet.

About the Author

Jeremy Ousey is the owner at Swansea's podiatry clinic: Keep On Your Feet. All the information found on this page was written by him (there's no AI or Chat-GPT here!), and has been carefully chosen to provide you with the information that you need to know about the condition. Jeremy has a Bachelor of Science in Podiatry, with honours, a Post-Graduate Certificate in Podiatric Sports Medicine, a Post-Graduate Diploma in Medical Ultrasound, and two Master's of Science degrees in the Theory of Podiatric Surgery, and Sports & Exercise Medicine. If you would like to know more about Jeremy, please click here.

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