Bunion & Hallux Valgus

Bunions are a very common condition, mainly affecting the female population due to improper footwear. If your big toe looks distorted and protrudes from the side of your foot, you may have a Bunion. A Bunion is a bony protrusion of the big toe joint that can cause friction and pain when wearing shoes. The condition in which the big toe deviates inwards is called Hallux Valgus. With the continued movement of the big toe towards the smaller toes, a bunion can result in the big toe resting under or over the second toe. This placement causes a common forefoot condition called overlapping toes. There are three degrees of bunions: mild, moderate and severe. Bunions are not hereditary, although the tendency to over-pronate, which is the cause of bunions, has a hereditary component.

Patients complain of pain in the metatarsophalangeal (MTP) joint and have a deformed (medially deviated) big toe. Often, they are only able to wear very wide shoes. Prolonged pressure against the medial aspect of the first MTP joint can lead to thickening of the medial capsule and bursa, resulting in severe valgus deformity of the great toe. Normally “toe-off” occurs from the plantar surface of the big toe. Over-pronation can cause the propulsion phase of stance to take off from the medial aspect of the phalanges of the big toe instead of the plantar surface. As a result, there is a retrograde force into the joint which pushes it out medially and stretches the joint capsule. This tearing and stretching of the joint capsule as well as the wear and tear on the cartilage causes the pain.

Podiapro can help by fitting orthotics that correct over-pronation and offload pressure from the first metatarsal head. Orthotics do not cause the physical condition to improve; they simply reduce the pain by providing support and offloading. They also help prevent the condition from worsening.