Bunions-Hallux Valgus

Hallux valgus is the medical term for a bunion deformity involving the large big toe joint. In the simplest terms, it is a partial dislocation, or in the most advanced cases a complete dislocation, of the joint at the base of the big toe. As the big toe progressively dislocates towards the small toes, the head of the 1st metatarsal becomes more prominent, and can become painful. Despite what a bunion looks like, it is not an abnormal growth of bone or a tumor. The gradual dislocation of the joint causes abnormal function, and as the big toe goes in one direction, the first metatarsal head goes in the opposite direction and becomes prominent. Any joint in the body that is partially or completely dislocated cannot function normally until it is corrected.

As this joint progressively moves out of place, it causes increasing pain, local swelling, and redness due to irritation from shoes. There also may be an associated “burning” sensation due to the fact that one of the nerves in the area gets pressed up against the prominent bone from your shoes.

Causes Of Bunions

Bunion deformities are certainly very common in some family groups, and therefore there is a significant hereditary factor involved in the development of this deformity. Abnormal mechanical function of the foot is also a major cause in the development of bunion deformities. A small percentage of individuals are actually born with bunion deformities. Statistically, more women have symptomatic bunion deformities than men.

As these deformities progress, the big toe will eventually position itself beneath the 2nd and 3rd toes which will result in hammertoe deformities of these digits. In some more advanced cases, a bursal sack (fluid filled cyst) will develop between the skin and the joint. This is the body’s attempt to cushion the area, but it actually results in more pain. To avoid this, it is best to get a bunion treated as soon as it begins to form.

Note that high-heeled shoes, pointed shoes, shoes that are too short or too narrow will severely aggravate a bunion deformity. Shoes, however, do not cause bunion deformities, but simply aggravate deformities that are developing or already exist.

Treatment For Bunions

Bunions are a complex deformity. When this joint is not functioning normally then it will have a direct negative effect on the function of the remainder of the foot and ankle over time. Appropriate history and physical examination, bio-mechanical evaluation, and x-ray evaluation are necessary to make an accurate diagnosis, and to be able to recommend an appropriate treatment plan to the patient.

Conservatively, shoe modifications, foot padding, anti-inflammatory medication, orthoses, and occasionally alternative pain-relieving treatment may be recommended to a patient in an attempt to diminish or eliminate their painful symptoms. Splints or digital wedges will not be effective in permanently realigning the joint. Conservative treatments will not change the structural position of the joint.

Dr. Cockrell may discuss and recommend surgical treatment. There are dozens of surgical procedures which have been developed over the past 150 years to treat bunion deformities. Appropriate surgical treatment of a bunion is based on proper evaluation, and determination if your deformity is positional or structural.

As a general rule, bunion surgical procedures are performed on an out-patient basis in approved Surgical Centers or in a Hospital. It is not uncommon that when you’re bunion deformity is being surgically treated, that other deformities that have developed, such as hammertoes, corns, or calluses that will be treated surgically at the same time.

Recovery For Bunion Treatment

Following surgery, the foot is bandaged and a post operative shoe is worn for one week. Athletic shoes may be worn after the first week. Weight-bearing exercise and prolonged standing are restricted for the first 6-8 weeks. A home exercise program is important for regaining the strength and flexibility. You may steadily resume activities and wear more fashionable shoes after healing is complete.

Please call our Brentwood/Franklin or Nashville area podiatry office at 615.370.8880 if you have any additional questions and we will be happy to provide you with all the information that you may need.