Bunions are a common feature of feet but most of the time they cause the owner nothing more than some mild embarrassment. There is no known cause of bunions but they tend to be genetic. There are two types- the first type effects young adults and the primary pathology is a splayed out bone of the 1st toe. The second type is the elderly lady (occasionally man) with degenerative changes in 1st toe and secondary changes in adjoining toes.
Ill fitting shoes are NOT a cause of this problem but can accentuate symptoms once the problem is moderately severe.
From a physio perspective the changes that occur at the 1st toe causes changes in the foot position, which in turn can affect the knee and hip. Often I see a degenerative knee or hip on the same side as a hallux valgus toe whilst the other side is normal. This occurrence I’m sure is not coincidental.
It is important to treat a HV toe to prevent problems occurring at the knee and hip, even if the foot is not in pain.
Treatment involves
- Foot muscle strengthening to promote a stronger arch and slow down the progression of the valgus (outward) movement of the 1st toe.
- Dynamic balance exercises are important in elderly to decrease risk of falls (since the 1st toe is essential part of balance).
- Correct footwear that supports the arch and prevents excessive load bearing on the medial pad of the 1st toe.
If conservative treatment fails to moderate pain then surgery is indicated. In my experience this result does not commonly result in happiness and so my advice to you is have your bunions checked even if you have no pain in your feet.
