Hallux Valgus - Bunions

What is it?

A bunion is a lump at the base of the big toe. While arthritis of the big toe can also cause this, a bunion generally results from the big toe pointing off towards the second toe. It may angle across enough to tuck under the 2nd toe.

What Causes it?

Many causes have been suggested but while it occurs more frequently in women and in people whose relatives have bunions, it is extremely common that no underlying cause is identified. Tight fitting pointed shoes may not initially cause the problem but they will certainly intensify the symptoms.

What are the symptoms?

Pain is usually the most significant problem. It may be felt over the bunion itself which may became red and inflamed. If the big toe has caused the second toe to lift up (Claw) then pain may be most prominent underneath the ball of the foot along with patches of hard skin (callosities).

How is the diagnosis made?

The doctor will listen to the description of the symptoms and will examine the foot and ankle. Plain X-rays are usually sufficient to make the diagnosis.

What is the initial treatment?

Pain under the foot or over the bunion can be effectively relieved by wearing wider shoes with an insole (orthotic) to take the pressure off the painful areas.

If initial treatment doesn't work, what's next?

Surgical realignment of the big toe metatarsal (ray of the foot) makes the bunion smaller and results in the big toe pointing in the right direction. There are a number of different ways of cutting the bone and moving it depending on how bad the deformity is. It is often helpful to realign one of the bones of the big toe itself. If the main problem is pain under the ball of the foot, it may be necessary to shorten some of the other rays of the foot (Weils osteotomies).

All of these operations involve using screws to hold the bone in its new position while it heals.




Our practice covers the following hospitals:

Parkside Hospital
For appointments phone : 0208 971 8026

St Anthony's Hospital
For appointments phone : 0208 335 4678

Ashtead Hospital
For appointments phone : 01372 221441
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New Victoria Hospital
For appointments phone : 0208 9499000

Clock House Hospital
For appointments phone : 01372 840837