Bunions or Hallux Abducto Valgus (HAV)
Is your big toe pointing towards the small toes? Do you have a bony growth on the side of the big toe? Or your smaller toes are already curling up as a result of deviation of the big toe? You’re not alone!
What is it?
HAV is the condition when the big toe deviates laterally (pointing towards the smaller toes). When this happens, a bunion or bony growth may develop on the side or over the top of the big toe joint. If treatment gets delayed, the angle of deviation may increase over time, and the bunion may get larger and could end up in secondary issues including osteoarthritis. Likewise, other smaller toes of the foot may also deform causing hammertoes or clawed toes. Bunions and hammertoes are progressive and do not go away by themselves.
The main symptom of HAV is pain during walking or movement of the hallux (big toe). This pain is due to the degeneration of the cartilage of the joint that occurs during the formation of the bunion. Long standing HAV can also cause the neighbouring 2nd toe to retract and dislocate. This dislocation can lead to the formation of corns and calluses under the ball of the foot which can become a painful part of the foot.
Treatment
Your podiatrist will assess your foot and identify the severity of your bunion. A full biomechanical assessment is advised to determine the cause and to develop an individualised treatment plan. The treatment plan will depend on the severity and the cause of the bunion. Underlying medical conditions, such as Rheumatoid Arthritis, need to be excluded. Minor deformities are predominantly caused by over pronation of the feet. The pain associated with these deformities can be decreased and any further joint degeneration can be limited with the use of orthotics and proper fitting shoes. Major deformities may require surgical correction to restore the alignment and function of the 1st MTPJ (big toe joint). Post surgical orthotics are usually required to slow if not prevent any recurrence of the bunion.
