Bunions (Hallux Abducto Valgus)

 

Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

 

What is a Bunion?


A bunion (also referred to as Hallux Valgus or Hallux Abducto Valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms may appear at later stages.

Causes


Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.

Symptoms


Symptoms, which occur at the site of the bunion, may include:

  • Pain or soreness
  • Inflammation and redness
  • A burning sensation
  • Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Diagnosis


Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred.

Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Once Mr Edwards has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

When Is Surgery Needed?

Indications for treatment are:

Pain, infection or irritation with footwear.  If you suffer from one or more of these then surgical treatment of your bunion is appropriate.

“I have performed over 2,500 Bunions operations. I advise patients not to wait and suffer, watching their Bunions progress, treat them early. This reduces their post-operative recovery time and simplifies their procedure”.  Mr S R Edwards FNZCPS

If a bunion interferes with daily activities, it’s time to discuss surgical options . Together, Mr Edwards and you can decide if surgery is best for you.

A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the “bump” of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred.  The goal of surgery is the long-term reduction of pain and the return to a normal foot function.

In selecting the procedure or combination of procedures for your particular case, Mr Edwards will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

 

Contact

For further advice or to make an appointment, please contact one of our professional team, our numbers and contact details are listed on the Contact page.

 

Stiff Big Toe (Hallux Rigidus)

The function of the toes, especially the big toe, is to help us balance, and to propel us forward during walking or running. One of the most common complaints is "Hallux Abducto Valgus", better known as a Bunion. American research has indicated that Women suffer from bunion deformities 4 to 6 times more frequently than men. However, a complaint that can also cause pain at the big toe joint which, according to research, is actually more common among men than women, is Hallux Rigidus.

What is Hallux Rigidus?

Hallux Rigidus, “stiff big toe,” is a commonly occurring condition of degenerative arthritis (a wearing out of surfaces) affecting the big toe joint. The condition results over time from constant wear and stress or from an injury to the joint. The result of the condition is pain, swelling, and/or restriction of movement; eventually the sufferer will stop bending the joint when transferring weight to the other foot, as in walking or running. Women will probably have to stop wearing shoes with high heels.

Symptoms of Hallux Rigidus

Two problems result from Hallux Rigidus: pain and stiffness (loss of motion). Walking is painful and difficult, since the MPJ joint cannot move enough to allow the foot to “roll through” while walking.

Causes of Hallux Rigidus

In most cases, there is no definite cause of this condition. Because of the tremendous stress put on this small joint over time (a force equal to twice one’s body weight), eventually the joint simply begins to wear out. It can affect fairly young people, even as young as teenagers.


Hallux Rigidus can also result from an injury or as a complication of another medical condition, such as Gout or infection.  It can also result from mechanical or anatomical problems in the foot and ankle, excessive pronation (rolling in) of the ankles, as well as toe deformities, which increase the stress on the joint.

Treatment of Hallux Rigidus

As a form of degenerative arthritis, treatment begins with anti-inflammatory medication. Other conservative treatments include:

As with Bunion deformities, there are several types of surgical procedures available to treat Hallux Rigidus, depending on the severity of the case.

So, if you suffer from a painful big toe joint, you don’t have to put up with it.

Early treatment is recommended to help avoid irreparable damage at the big toe joint surface.

 

Sesamoiditis

 

What is Sesamoiditis? “Pain under the ball of the big toe”

Most bones in the human body are connected to each other at joints. But there are a few bones that are not connected to any other bone. Instead, they are connected only to tendons or are embedded in muscle. These are called the Sesamoids. The kneecap (patella) is the largest Sesamoid. Two other very small Sesamoids (about the size of a kernel of corn) are found in the underside of the forefoot near the big toe, one on the outer side of the foot and the other closer to the middle of the foot. Sesamoids act like pulleys. They provide a smooth surface over which the tendons slide, thus increasing the ability of the tendons to transmit muscle forces. The Sesamoids in the forefoot also assist with weight bearing and help elevate the bones of the big toe.

Signs and symptoms of Sesamoiditis

  • Pain is focused under the big toe on the ball of the foot.
  • With Sesamoiditis, pain may develop gradually.
  • With a fracture, pain will be immediate.
  • Swelling and bruising may or may not be present.
  • You may experience difficulty and pain in bending and straightening the big toe.

Causes of Sesamoiditis

Sesamoid pain can develop ina number of different ways.

Abnormal position of the Big toe joint can result in it’s overloading and like other bones, the Sesamoids underneath the big toe can break (fracture). Fractures can also cause pain in the Sesamoids.

Fractures can occur when a person falls and lands bluntly on the ball of the foot. Stress fractures can also occur in the Sesamoid bones. Stress fractures are usually caused by the strain of overworking the soft tissues. Athletes most often suffer stress fractures of the sesamoids because of the heavy and repeated demands that training places on the soft tissues of the foot and big toe.

Additionally, the tendons surrounding the Sesamoids can become irritated or inflamed. When the tissues around the sesamoid bones become inflamed, doctors call the condition sesamoiditis. Sesamoiditis is often caused by doing the same types of toe movements over and over again, which happens in activities like running and dancing.

Arthritis can develop where the sesamoids glide under the bone of the big toe. The sesamoid bones create a joint where they move against the bone of the big toe. Like other joints in the body, this joint can also develop arthritis. Arthritis is more likely to be a problem in people who have high arches in their feet. The high arch causes the main joint of the big toe to become rigid. This focuses strain and pressure on the sesamoids.

In some cases, blood supply to the sesamoid bone is decreased. This condition is called osteochondritis.  Osteochondritis causes a piece of the bone to actually die. The body's attempts to heal the area may build up extra calcium around the dead spot.

Treatment of Sesamoiditis

  • Stop the activity causing the pain.
  • Return to activity gradually, and avoid activities that put your weight on the balls of the feet.
  • Cushioning pads can be helpful as the fracture heals.

If conservative treatment fails you will need to consult Mr Edwards who will be able to help.


Contact

For further advice or to make an appointment, please contact one of our professional team, our numbers and contact details are listed on the Contact page.