Description

A bunion is a deformity characterized by an enlargement of bone or tissue around the joint at the base of the big toe. This enlargement causes lateral deviation of the great toe often forcing it towards, and sometimes under, or over adjacent toes. Hallux Valgus is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint. As both Hallux Valgus and Bunions commonly occur together, they are often simply referred to as Bunions. Bunions are a progressive deformity, and if left untreated the bump may become larger. This type of deformity will most commonly affect adults, and some studies report that bunions occur nearly ten times more frequently in women than men. Primary causes of this condition are generally related to poor biomechanics and is usually hereditary. Poor fitting shoes can aggravate the condition, however this is not usually the primary cause.

Symptoms

There are degrees of severity in regards to hallux valgus and bunion formation. Pain, a common complaint, seems to be related to the degree of severity and can be devastating as the great toe migrates into/over/under the second toe; resulting in excess pressure at the joint from the shoes rubbing/chafing the bump/bunion. The deformation can be unsightly and makes finding a proper fit in footwear difficult. Painful wet/soft corns can develop between the toes.

Pedorthic Management

• Orthopedic footwear – educate clients about appropriate footwear selection regarding fit, function and support. Footwear should be wide and deep in the toe box to accommodate the bunion.
• Modify footwear as required – some may require a balloon patch or ring and ball stretcher at the bunion to allow for extra space for the bump or a rocker sole to help the individual flow through their gait without putting pressure on the great toe.
• Custom made orthotics –  to provide proper support and alignment to the foot, which can slow or halt the progression of bunions by addressing the instability which causes the deformity (orthotics cannot reduce the pre-existing bony deformity).
• Toe spacers – to reduce overlapping and chafing
• Protective shield bunion pads – to reduce rubbing and blistering
• Hallux valgus day/night time splints – The day version are usually flexible and can be worn in shoes where as night version are made out of a rigid material but both are built to serve the same purpose – to pull the hallux (big toe) back toward the midline of the body or away from the 2nd toe – gently stretching the tendon and toe muscles.

Other Treatments/Modalities

• Traction and concentrated vibration therapy
• Reconstructive therapy
• Stretching/flexibility exercises
• Reduction / Corrective surgery