Bunion (hallux valgus): causes, symptoms and treatment

Bunion, or hallux valgus, is a foot deformity in which the big toe gradually leans toward the other toes, while a bony bump known as a bunion protrudes on the inner side of the foot. It is a progressive condition: the longer it is neglected, the greater the deviation of the toe and the more painful the bump, and the harder it is to treat. Besides being a cosmetic concern, a bunion over time makes walking and wearing shoes difficult and can disturb the support and balance of the whole foot, as well as the position of the other toes. That is why it is important to react early, while the deformity is smaller.

Symptoms of a bunion

Bunion is easily recognized by its appearance, but the complaints are often painful too. The most common symptoms are:

• a visible bony bump next to the base of the big toe,
• the big toe leaning toward the second toe, which over time may lift or overlap,
• pain, redness and swelling on the bump, especially in shoes,
• calluses and thickened skin at the pressure point,
• pain when walking and a feeling of quick foot fatigue.

Causes and risk factors

Bunion develops from a combination of a hereditary tendency and external factors. The most important causes and risk factors are:

• a hereditary foot structure and joint laxity,
• wearing tight, pointed shoes and high heels,
• flat feet and weakness of the small foot muscles,
• overload of the front part of the foot,
• female sex and age, since the deformity increases over the years.

How the diagnosis is made

The diagnosis is made by examining the foot and assessing the degree of toe deviation and joint mobility, while an X ray precisely shows the angle of the deformity and the condition of the joint. Based on that we assess whether conservative treatment is enough or whether, in advanced cases, an orthopedic, that is surgical, approach is needed.

Treatment of a bunion

In the earlier stage, treatment of a bunion at the Dynamic Fizio center is aimed at reducing pain and slowing the deformity through physical therapy and exercises, which often avoids or delays surgery. We use:

• tecar therapy and electrotherapy to reduce pain and inflammation of the bump,
• exercises to strengthen the small foot and toe muscles that slow the deviation,
• manual techniques and stretching for better toe mobility,
• advice on suitable footwear, insoles, toe separators and night splints.

Exercises and everyday tips

Simple exercises are useful: gripping a towel or small objects with the toes, spreading the toes apart, and walking barefoot on a soft surface to strengthen the muscles. For footwear the rule is that the toe box must be wide enough for the toes to stand naturally without being squeezed, and the heel moderate.

How treatment works at our center

Treatment starts with a free first examination, where we assess the degree of toe deviation, joint mobility, the condition of the skin on the bump and the way you bear weight on the foot. Based on that we build an individual plan that in the earlier stage reduces pain and inflammation and slows progression of the deformity. Therapy combines devices with exercises to strengthen the foot and toe muscles, and we give concrete advice on footwear, insoles and toe separators, with a clear explanation of what therapy can and cannot achieve.

Frequently asked questions

Can a bunion be corrected without surgery? Physical therapy and exercises cannot correct an already formed bony deformity, but they can significantly reduce pain, slow progression and delay or avoid surgery, especially if started early.

Do toe separators help? They can reduce pressure and complaints and slow the deviation, but they work best together with exercises and proper footwear.

When is surgery needed? When the deformity is pronounced, the pain is strong and the bunion significantly interferes with walking and the choice of footwear, despite conservative treatment.

Must I completely give up high heels? Occasional wear is not forbidden, but daily high and tight shoes speed the deviation of the toe, so for regular wear it is better to choose more comfortable footwear.

Does walking barefoot help? Walking barefoot on a soft surface strengthens the small foot muscles, which helps slow the progression of the deformity.

Is a bunion only a cosmetic problem? No. Besides appearance, over time it causes pain, calluses and changes the support of the foot and the position of the other toes, so it should not be ignored.

Does a bunion hurt in everyone? No. In some people the bump does not hurt for a long time, but even then exercises and proper footwear help slow the progression of the deformity.

Does it occur in men too? It is more common in women, but it also occurs in men, especially with a hereditary tendency and overload of the foot.

Do silicone toe separators help? They can reduce pressure and friction and ease complaints, and they are best combined with exercises to strengthen the foot muscles and suitable footwear.

If a bunion and foot pain are bothering you, book a free first examination at 060/134-3303.