Hallux valgus (bunion) Abnormal position of the big toe

A hallux valgus is a very common condition. It involves an abnormal position of the big toe. In addition to the fact that this can be troublesome and painful, some patients also find it unsightly.

An estimated 33% of all adults have a hallux valgus position abnormality to a certain extent. It is more common in women than in men.

Hallux valgus is a condition that involves the big toe bending toward the other toes. The metatarsal bone that is located just before the big toe is rotated in the other direction (outward). This results in a lump on the outside of the big toe. This is called a "bunion".

It is not entirely clear exactly how hallux valgus develops. It can be the result of a congenital abnormality in the foot, hypermobility of the joints and excessive inward sagging of the foot. Tight, narrow shoes or shoes with high heels appear to increase the risk of developing a hallux valgus.

It is more common in some families. In addition, hallux valgus is more common with diseases that cause inflammation of the joints, such as rheumatoid arthritis.

To diagnose hallux valgus, the healthcare professional will ask about the complaints and how they have developed. In cases of a more advanced hallux valgus, diagnosis is not difficult. The big toe will already be pointing inward and a painful bump is present.

Treatment is usually conservative. This means that the patient will be given the advice to wear wider shoes with low heels. Foot exercises can preserve joint mobility. Insoles or a night-time splint can combat the skewed position.

A surgical procedure may be considered if the condition causes severe pain or nuisance. Various techniques are used, which generally yield good results.

Verhaar, J.A.N. & Linden, A.J. van der (2005) Orthopedie Houten: Bohn Stafleu van Loghum.
Barg, E.C., Eekhof, J.A.H. & Knuistingh Neven, A. (2008) Hallux valgus Kleine kwaal. Huisarts & Wetenschap. Feb; 51(2):96-98.