Bunions (Hallux Valgus): Causes, Symptoms, Treatment and Cost

Bunions, also called hallux valgus, are a common foot problem. They occur when the big toe is angled in towards the other toes and an enlargement of tissue or bone forms on the joint at the bottom of the big toe.

Mainly there are 2 types of bunions. They differ in their cause and the treatment methods that are most effective.

• Primary Bunion: A primary bunion is the most common type and is usually caused by a combination of factors such as heredity, misaligned joints, and poor-fitting shoes. This particular type of bunion will typically not be treated surgically and can often be managed with conservative treatments such as anti-inflammatory medications, physical therapy, bunion splints, orthotics, or lifestyle changes.
• Secondary Bunion: While some cases can be similar to a primary bunion, a secondary bunion is typically caused by an underlying medical condition such as arthritis or gout. This type of bunion may be treated more aggressively with surgery due to the fact that it is often more severe than a primary bunion.

Poorly-fitting footwear, such as high heels or pointed shoes: wearing ill-fitting shoes can cause pressure and friction on the bunion, leading to swelling and pain.

• Genetics: Sometimes they are inherited from parents and may be caused by an inherited faulty mechanical structure of the foot.
• Arthritis: Certain types of arthritis can cause changes in the joint that leads to a bunion forming.
• Structural Foot Abnormalities: Abnormal inward angulation of the big toe joint or an abnormally long first metatarsal bone can predispose one to developing bunions due to increased stresses on the joint that result in deformity.

• Painful bump, tenderness, or swelling on the side of the big toe.
• Redness, soreness, and/or inflammation around the big toe joint.
• Overlapping of the big toe onto or over its adjacent toe.
• Thickening of skin around the affected area.
• Difficulty in walking and also feeling of discomfort while wearing shoes due to pressure from asymmetrical joints.

• Prefer wearing shoes that fit properly and have wide toe boxes to avoid discomfort.
• Take breaks from high heeled shoes and wear comfortable, low-heeled styles instead.
• Stretch your feet regularly throughout the day to reduce tension in tight tissues and muscles.
• Ensure your socks don't put excess strain on your toes by being too tight or loose around them.
• Exercise regularly to maintain strong leg muscles, good balance, and good posture.
• Maintain a healthy weight as additional body weight can increase foot stress when walking and running.

• X-rays: X-rays may be taken in order to check the severity of the bunion. They may also be used to identify any existing foot deformities that may have caused the bunion such as flatfoot, high arched foot and bone abnormalities like osteoarthritis.
• Ultrasound: Ultrasound is a noninvasive imaging test that uses sound waves to create an image of the foot structure. It can provide information about the shape and size of the bones and soft tissues around the bunion.
• Blood tests: To rule out any underlying medical conditions that could be contributing factors.
• Meary’s angle test: Meary’s angle is a test used to diagnose bunion (Hallux valgus) deformities. It measures the angle between the first and second metatarsal bones of the foot when viewed from the side, and is used in determining the severity of bunions and determining if surgery is needed.

• Joint pain: Bunions can cause pain in the big toe joint due to its abnormal angle.
• Bursitis: Swelling around the joint may occur due to a fluid-filled sac (bursa) becoming inflamed from pressure of the bunion or the shoe rubbing against it.
• Arthritis: Osteoarthritis in the big toe joint may be caused by long-term misalignment of the joint.
• Changes to surrounding toes: Hammertoes and crossover toes can form as nearby result from changes in foot structure due to bunions, which may cause further discomfort and altered movement of the foot.
• Skin problems: Rubbing of shoes against bunions leads to irritation and possible skin problems, such as calluses and ulceration.

• Applying warm sesame oil or castor oil to the affected area, along with gentle massage, can help reduce swelling and reduce pain.
• Taking ginger or turmeric internally is effective in reducing inflammation and pain caused by bunions due to its anti-inflammatory properties.
• A paste created with 1 tsp of ghee, 1 tsp of barley powder, a pinch of rock salt and a pinch of poppy seeds can be applied over the bunion twice daily for relief from pain and inflammation.
• Taking garlic internally can help relieve inflammation due to its antioxidant properties as well as improve blood circulation in the foot, helping to relieve discomfort associated with bunions.

• Eating a balanced diet with lots of fresh fruits, vegetables, and whole grains is important for reducing inflammation and helping to maintain a healthy body weight.
• Foods that are high in antioxidants, such as berries and green leafy vegetables, can help reduce inflammation throughout the body.
• Magnesium-rich foods such as nuts, seeds, avocados, bananas, whole grains and dark chocolate are great for reducing muscle tension in the feet which can help relieve some of the pressure on bunions.
• Incorporating healthy fats like olive oil into your meals can also be beneficial for increasing circulation to the feet which can help reduce pain associated with bunions.

• High sugar foods such as cakes, doughnuts, candies and soft drinks.
• Fried, greasy or processed foods such as French fries, processed meats, and frozen dinners.
• Refined carbohydrates such as white breads, pasta and crackers.
• Animal fats like lard, butter and margarine.
• Processed protein foods like processed cheese and burgers.
• Dairy products like cheese, ice cream and butter.
• Alcoholic Beverages.

• Orthotics: These special shoe inserts can reduce pressure on the bunion, improving comfort and reducing pain.
• Physical Therapy: Exercises that can help in strengthening the muscles around the bunion that further improve balance and circulation and thus reduce discomfort when wearing shoes or orthotics.
• Realignment osteotomy: Involves cutting and realigning bones to correct positioning of the joint.
• Soft tissue repair: Involves making a small incision in the soft tissue around and overlying the bunion and suturing it over the head of the first metatarsal bone to reduce tension on the joint capsule.
• Arthrodesis: Involves fusing together two or three joints in order to maintain proper alignment and provide stability or secure an exposed joint from further damage or misalignment due to motion/weight-bearing activity.
• Arthroplasty/implants: Articular cartilage is replaced with metallic implants which help line up bones correctly while providing stability in movement activities such as walking or running on uneven terrain that would otherwise cause pain, deformity, and instability issues with hallux valgus displacement.

The best medical professional to consult for bunions is an orthopaedic or foot doctor (podiatrist). They will be able to diagnose the problem and offer treatment options to reduce symptoms and improve mobility.

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These drugs work by reducing swelling, pain, and inflammation associated with bunions. Examples of NSAIDs include ibuprofen, naproxen, and aspirin.
• Corticosteroids: These medications reduce pain and inflammation associated with bunions by suppressing the body's immune response. Examples of corticosteroids include prednisone and Dexamethasone.

The amount of time it takes to recover from bunions (Hallux Valgus) varies depending on the severity of the condition and treatment chosen.

In mild cases, a bunion can be treated with self-care measures and adjustments to shoes, which may take up to 4-6 weeks.

For more severe bunions, surgery may be necessary, which typically requires up to 6-12 weeks for complete recovery.

The cost of bunions (Hallux Valgus) treatment in India varies depending on the severity of the condition and the type of treatment required.

Generally, treatments can range from conservative methods such as orthotics and padding, which may cost around ₹500 - ₹1000, to surgical procedures such as bunionectomy or osteotomy, which may cost up to ₹40000 - ₹50000.

Common side effects may include:

• Temporary feet or toe stiffness
• Swelling
• Bruising
• Bleeding
• Infection.
• In some cases, nerve damage and permanent loss of motion may occur.
• Patients may also experience pain during or after the procedure.

Additionally, surgical options can involve a long recovery period with extended discomfort as well as possible complications such as chronic limb swelling or arthritis.

If you are going through any complications of Bunions (Hallux Valgus) then you should consult a doctor nearby as if not treated on time they can cause complications like 'bursitis, arthritis, skin problems' in which treatment courses can range from a few months to years depending on the severity of the situation.