BUNIONS (HALLUX VALGUS)

Conditions

Overview

BUNION PAIN

Most people think of a bunion as simply a bump on the side of the big toe joint. However, a bunion is a change in the anatomy of the foot, a progressive dislocation of the big toe.
Bunions can appear gradually, or more quickly over several months. Not only does the big toe gradually point toward the second toe, but changes take place in the alignment of the bones of the foot. The 1st metatarsal (the bone that makes up the big toe joint with the toe) shifts away from the foot, widening the foot and causing the bump we refer to as the bunion. This bump is really the head of the 1st metatarsal.
Anyone can get a bunion, but they are more common in women. Flat or overpronated feet, heredity, poor fitting shoes and arthritis are all possible causes.

BUNIONS

Observation is often enough to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. Your physician may order X-rays that will show the extent of the deformity of the foot and whether degenerative arthritis is also present.

Common Issues

The big toe (hallux) shifts towards the second toe
This is a progressive dislocation of the big toe joint
The base of the 1st metatarsal may become unstable as the metatarsal shifts inward, widening the forefoot
The combined misalignment makes the big toe inefficient as a push off mechanism for normal walking mechanics

Symptoms & Signs

It is not always a painful deformity and can be quite extensive with no pain at all
Appearance of a bump or enlargement at the base of the big toe (ball of the foot)
The big toe may crowd the second toe causing it to ride up on the big toe
The enlargement may be painful with shoe pressure or bending of the joint during walking
The skin can appear red, with swelling and a burning sensation

Treatment

Wide fitting footwear to accommodate the bunion
Deep toe box to reduce friction over the 2nd toe
Rockered forefoot in the footwear reduces joint strain during walking
Custom orthotics to improve foot mechanics
Toe spacers to promote straightening of the big toe ( we custom make silicone toe spacers and carry over the counter devices)
Specially designed socks that promote straightening of the big toe (discrete and fashionable varieties)
Exercises to improve the alignment of the big toe and 1st metatarsal

Hallux valgus, woman legs barefoot with bunions stand on green grass backgroud

Specific BUNION Conditions We Treat

How does it work?

Bunions are not always painful. But lack of pain isn’t a good excuse to keep wearing high heels and tight-fitting footwear. Leave them in your closet as they are one of the leading causes of bunions in women, and they can make the bunion worse.
While you may be referred to a surgeon to investigate surgical options, Canadian Certified Pedorthists have a variety of effective, non-surgical options.

Step 1

Book An Assessment

Call us or book a pedorthic assessment on line
An assessment to examine your bunion issues typically takes 30 to 45 minutes
If you have shorts, bring them(we also have shorts at the clinic)
Bring 2 or 3 pairs of the shoes you wear most often, for work and play
Bring your prescription if you have one and x-ray CD or report

step 2

During Your Assessment

Review the extent of your bunion deformity and pain, and discuss your x-ray or MRI results
Examine your muscle strength, structural alignment, joint ranges of motion with specific attention to your great toe joint, and how you walk ( gait assessment )
Answer any questions you may have relating to your bunion or your feet in general
Discuss the various orthotic options, cast your feet in either plaster, foam or 3D laser scan
Recommend or fit footwear
Provide strengthening exercises and mobility exercises to potentially improve your great toe alignment
Provide complimentary non-custom toe spacers, discuss other devices that provide relief, including custom toe spacers, and/or compression socks that improve big toe alignment while you wear them

step 3

Enjoy a Better Quality of Life

Typically, you will receive your orthotics in about 2 weeks
Within a few weeks of wearing them, you should be feeling less pain in your bunions
If necessary, we’ll have you come back for a follow up
Follow ups are for further modifications, and/or to review exercises and stretches, and footwear recommendations
At any point in the future, we encourage you to return for any necessary adjustments and service the orthotics if necessary

Frequently Asked Questions

1. What causes bunions?

Bunions may be hereditary or may be caused by poor fitting footwear. Poor foot mechanics or foot posture are likely causes. Feet that roll in excessively or flat feet are common examples of foot mechanics and foot posture.

2. Are there exercises that I can do to help prevent bunions?

Yes. Toe muscle strength is very important. Try picking up your sock or gathering a towel with your toes while your heel is elevated off the floor. And try to use your mind to spread your toes actively while you are seated.

3. Is surgery an option?

Surgery is an option for the most extreme misalignment or when pain level is exquisite. Consult your physician for the possibility of a referral to an orthopaedic surgeon for a consult.

Ready to Get Started

Request An appointment

Assessments are typically 30 to 60 minutes depending on your ailment and your needs. Bring shorts to change into if necessary, your footwear that you work in, and what you wear after work. If you have these, bring the prescription or referral from your referring medical professional, and the x-ray or MRI report.