A bunion, medically known as hallux valgus, is characteristic of an angular bony protrusion that forms at the site of the large joint that connects your big toe to your foot.
This joint, called the first metatarsophalangeal joint (or MTP joint for short), is a critical junction of bones, tendons, and ligaments that bear much of our weight when we’re on our feet. With this deformity, the big toe slowly and gradually turns towards the lesser toes as the joint deviates from proper alignment.
This foot deformity occurs in about 10-30% of the population, affecting twice as many females than males. Bunions are caused by wearing poor-fitting shoes, faulty foot mechanics, muscle imbalances, lax ligaments, inflammatory arthritic conditions, and genetics.
Bunions can be asymptomatic, although some people may experience pain, redness, and swelling at the joint, especially with tight footwear and extended periods of standing or walking. Symptoms tend to subside with rest.
Unfortunately, a bunion is a progressive deformity and is irreversible without surgical intervention. This means they will slowly get worse over time. They are categorized in stages to determine the severity of the deformity.
Without treatment, there is a greater risk a bunion will progress from one stage to the next.
Stages of Bunions
Stage 1
Visually, a bunion at this stage is considered mild. There may be a small “bump” at the side of the 1st MTP joint and the big toe will be slightly turned towards the second toe, although not touching it.
Stage 2
Big toe further deviates from the MTP joint. At this stage, the 1st toe may be touching the 2nd toe beside it.
Stage 3
The bony protrusion at the base of the big toe is significant because at this stage, the base of the 1st toe has developed a bone spur. The 1st toe also starts to rotate on its axis away from the mid-line of the body.
Stage 4
The 1st MTP joint has dislocated and the 1st toe will under ride or override the 2nd toe. At this stage, the 2nd toe will also present with a hammer toe deformity.
Although the only way to reverse a bunion is by surgery, it is recommended if symptoms are not manageable by conservative measures and if function is severely compromised.
Conservative bunion management includes custom foot orthotics, splints, bunions guards, toe separators, and foot exercises.
Conservative treatments help to slow down the progression of a bunion as well as manage pain.
Talk to your Chiropodist about the stage of your bunions and which conservative treatment options would be best for you!