Bunion (Hallux Valgus)

What are the symptoms?

Not all HAV’s are painful.

Some people have large HAV’s that are painless but cause difficulties with footwear, while others have relatively small HAV’s that can be very painful. 

Although some treatments can ease the pain in the joint, only surgery can correct the joint position. 

Symptoms may include:

• Bony lump on the side of the big toe joint
• Deviation and rotation of the big toe towards the 2nd toe
• Pain and swelling of the big toe joint
• Stiffness of the big toe joint
• An open wound over the bony prominence  
• Bursa (fluid filled sac), corn/callous over the side of the joint
• Smaller toe deformities

For further information see NHS Inform links at the bottom of this page.

What treatments are available?

Advice is aimed at reducing pressures around the joint to relieve symptoms but this will not correct the position of the toe.

Footwear -  It is important to wear footwear that is wide and deep at the front of the shoe with minimal stitching. Avoid backless, high heeled shoes. Wear a shoe with a lace or strap over the instep to hold the foot secure.

Exercises -  to help with foot function and reduce load on the front of the foot when we walk we need a good range of motion at the ankle joint. If the calf muscles are tight it is important to stretch these. 

Exercising the foot muscles can help with improved balance and strength 

• • See Intrinsic Foot Exercises

Taping - This can be used on smaller joints to relieve some symptoms.

• • See Taping Advice

Bunion braces/splints/shields - there is limited evidence to support the use of the braces and splints, however they can occasionally provide some relief from symptoms. The shields can prevent rubbing from footwear.

Insoles/Orthoses - you may wish to try a simple arch support insole which may help to relieve symptoms for some people, but only in combination with a good fitting shoe.  

Pain Relief - using a heat pack on a painful joint may help the pain and stiffness.

An ice pack may also help. It is important to wrap with a cloth and do not apply directly to the skin for both heat and cold. How long you use heat or ice as a treatment may vary. However, you should generally apply heat or ice for up to 15 minutes.

You should also leave a few hours between treatments. You should stop treating if you notice redness, discolouration or blistering of the skin.

If you have diabetes mellitus, poor circulation, or loss of feeling in your feet, avoid these treatments options.

Over the counter painkillers such as paracetamol or topical anti-inflammatory gels may ease the pain, always follow the instructions on the packet or speak with your local pharmacist if in doubt.

Please see NHS Inform link About taking painkillers below for more information on pain relief. Your podiatrist or GP may advise tablets that reduce inflammation e.g. Ibuprofen (see GP or Pharmacist for further advice).

Surgery - if, following all podiatry interventions, you continue to experience significant pain  referral for an Orthopaedic opinion to discuss surgical options available to you if appropriate. Surgery should only be considered if ALL non surgical interventions have been unsuccessful.