![]() Claw toe splints can help to prevent lesser toes rubbing on shoes. A hallux valgus splint for night-time stretching helps to slow down progress, a spacer/spreader between the big toe and the second toe helps to avoid friction during the day, and a custom made arch support insole, made by a podiatrist, can correct any associated flat feet. Moderate deformity cases may be helped with the addition of ‘orthotics’. This may slow down the deterioration of the condition, but usually it does not completely stop the progress. In mild cases symptoms can be improved by adjusting shoes – such as wider shoes, soft materials, possibly custom-made shoes, and, as much as possible, avoiding very high heels. What are the treatment options for bunions? Because one has bunions it does not mean the bunion is automatically the source of any pain in the foot – new pains should be properly assessed. Often patients labeled with ‘gout’ turn out to have ‘hallux rigidus’.Īthletes with bunions can develop pain because of stress fractures and other problems. ![]() The only way to be absolutely sure is to take some joint fluid during an attack and examine it under the microscope for gout crystals. Pain at the base of the big toe is commonly diagnosed as gout, but confirming the diagnosis can be difficult. Sometimes one can have both problems, and in severe longstanding hallux valgus the joint often develop osteoarthritis. For information on hallux rigidus see the ‘Hallux Rigidus FAQs’. In hallux rigidus the joint at the base of the big toe is usually painful and stiff, whereas in hallux valgus the joint is deformed but usually not very painful. The other common cause of pain and swelling at the base of the big toe is osteoarthritis of the joint, known as ‘hallux rigidus’. The Meary line angle quantifies the severity. Right: Normal for comparison.įig.4 Weight bearing lateral X-ray of foot: The foot is flat. The sesamoid bones have displaced from the normal position beneath the big toe (circle). The angles HVA and IMA quantify the severity of the problem. 3, 4 & 5).īlood tests: are sometimes needed if there is a suspicion of inflammatory arthritis (such as Rheumatoid arthritis).įig 3a & b. X-rays: Weight-bearing X-rays are usually sufficient to understand the problem (Figs. ![]() History: Most patients complain of deformity and pain.Įxamination: Review the combination of problems described above. Hallux valgus usually gets worse over time. The second or other lesser toes may be deformed due to overcrowding and pressure, and they may have painful calluses on the sole. As the bunion enlarges, there is increasing difficulty to fit into shoes. Severe hallux valgus can lead to repeated inflammation and pain over the bunion where there is friction with shoe wear. Mild Hallux valgus may not have symptoms except for the prominence of the bunion.
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