Hallux Valgus (Bunion)
We'll bring your foot back into shape
The little bulge on the inside of your foot is getting bigger, like a ball. It’s as if another bone is growing there. At the same time, your big toe is becoming more and more crooked. Hallux Valgus is a visible displacement of the big toe. It could better be described as a crooked toe. It doesn’t just have visible symptoms – it also causes increasing foot pain.
What Causes Bunions
What is Hallux Valgus?
Hallux Valgus (bunion) is a disorder of the foot skeleton, where the big toe is no longer in its natural position. It angles itself towards the other toes and often displaces them. Sometimes, the toes even shift above or below one another.
This crookedness causes the ball region of your instep to bulge. A considerable bulge can be seen and felt. Hallux Valgus also alters the weight distribution across your entire foot and causes you to roll your foot while walking. This often involves a lot of foot pain.
Causes: how does Hallux Valgus occur?
Often, a bunion develops due to a combination of different factors. Hallux Valgus is sometimes inherited. If you have a known predisposition, years of wearing narrow, pointed shoes can be particularly unhelpful. Your foot muscles also cannot work correctly in high heels, and they lose strength and elasticity. This can cause toes to become displaced. Furthermore, studies have shown that even wearing socks for years presses toes together and changes the natural shape of your foot. Compression stockings are especially problematic.
Disorders that weaken connective tissue also increase the risk of Hallux Valgus, as your foot can quickly and easily become deformed. Because women naturally have weaker connective tissue, they’re also more likely to suffer from this disorder.
Symptoms: how do you identify Hallux Valgus?
In the early stages, the crooked toe will cause you hardly any discomfort. Then the small protruding head of the metatarsal bone on the inside of the foot will start to bother you. Your foot may no longer fit into tall, narrow women’s shoes. Your bunion will be thickened. This is why Hallux Valgus is also called “bunion”.
In the advanced stages, foot pain will occur. This will generally start in the region where the head of your metatarsal bone on the inside of your foot appears as a bulge. The greatly enlarged ball will press painfully against your shoe with every step. Your skin and the bursa underneath will permanently be irritated. Inflammation and swelling will occur. Because you’ll no longer be putting strain on your foot and the affected points will continue to press against the shoe, this can develop into a recurring and highly painful condition.
The toe joint of your big toe will also be adversely affected. Due to the changed position of your toe bones, your joint movements will change as well. The joint will then be worn down faster (arthritis) and will have less and less mobility. If your arthritis is already advanced, your foot will be most painful when you roll it while walking.
But it's not the pain in the big toe that often gets patients to visit their doctor. The crooked big toe pressing against the second toe is sometimes the biggest source of pain.
Diagnosis: how displacement in the foot is determined
In most cases, you can identify Hallux Valgus yourself before any foot pain even occurs. Your toes are turned inwards and the ball of your big toe is often painful, which causes problems when walking, standing or putting on shoes. Using x-ray images taken while standing under your full body weight, our specialists at Schoen Clinic can create an accurate clinical picture of your bone displacement.
Hallux Valgus (Bunion) Surgery
Hallux Valgus: surgery is not the only option
Together with our orthopeadic consultants, you can select the best-possible treatment according to the severity of your Hallux Valgus. At Schoen Clinic, we offer a full range of treatments. Conservative Hallux Valgus treatment, such as a Hallux Valgus splint, helps alleviate pain. The muscles in your foot can be specifically strengthened early on to prevent displacement from occurring. However, Hallux Valgus surgery is needed to permanently rectify the bone displacement, preferably before cartilage is damaged.
Conservative treatment methods
Hallux Valgus treatment: relieve acute pain without surgery
Conservative measures are suited to relieving acute pain and inflammation in your foot. Wide, soft shoes are beneficial during this phase. Strengthening your foot muscles through physiotherapy can also help. Shoe inserts or sensomotoric inserts for strengthening your foot muscles may provide relief as well. Furthermore, a Hallux Valgus splint can improve the symptoms in your affected foot.
In most cases, however, the displacement will continue to develop slowly despite all these measures. To actually correct the Hallux Valgus, surgery is necessary.
Surgical treatment methods
Hallux Valgus surgery: how we rectify displacements
We can correct a mild displacement with a scarf osteotomy. We cut into the first metatarsal bone using a V or L-shaped cut and move it back to its correct position. We then stabilise your bone using a wire or screw. The remaining bone is removed.
For severe displacements, the correction is made further in the direction of the midfoot (base wedge osteotomy). Using this surgical technique, we can also permanently correct severe Hallux Valgus.
We can rectify a bend inside your big toe by removing a small wedge of bone (Akin osteotomy).
If the first metatarsal joint is affected due to arthritis or instability, we correct the misalignment inside your joint.
You’ll be happy to know that your ankle joint and toe movement won’t be affected by Hallux Valgus surgery.
What happens afterwards: a special shoe supports the healing process
After surgery, your bone will need six to eight weeks to fully regenerate and stabilise. We prescribe a forefoot relief shoe during this phase to ensure there is no new displacement during the healing process. This will protect the operated foot, but after most surgeries, the heel of your foot can become fully strained. As soon as the wound has fully healed, you’ll be able to begin physiotherapy. Because your foot will often still be swollen or swell up under stress after the forefoot relief shoe is removed, we recommend soft, wide and comfortable shoes in the first few weeks after Hallux Valgus surgery. You’ll be able to wear all types of shoes again after three months, in our experience.
Complete regeneration of your foot may take up to six months. Afterwards, you’ll be able to practise sports again without limitations as part of the standard healing process.