Bunions (hallux rigidus)

A bunion is a bony hump at the base of the big toe. Hallux rigidus refers to a stiff big toe caused by degenerative arthritis or a bone spur that affects the joint at the base of the big toe.

Hallux rigidus, which occurs mainly in adolescents and adults, is a form of degenerative arthritis that causes stiffness in the big toe (hallux). The exact cause of the condition is not fully understood. Often it is believed to be caused by wear and tear in the joints of the big toe, and sometimes it may be related to previous trauma. Surgery can often help treat the condition.

A bunion (hallux valgus) is a painful bony swelling on the joint at the base of the big toe. Sometimes this can cause the big toe to be angled inwards, towards the middle of the foot and the second toe.

If a bunion becomes worse over time, it can cause further problems such as arthritis in the joint of the big toe. If painkillers, bunion pads or orthotic aids (such as wearing insoles) are unsuccessful at managing the symptoms of bunions, then surgery will usually be recommended.

Surgery is a successful treatment for around 90% of people, helping to relieve pain and improving the straightness of the big toe.

The underlying cause of a bunion is a joint deformity of the base of the big toe but it is not always clear why this deformity occurs in the first place. Possible reasons include:

  • a genetic tendency to a joint weakness/flat feet
  • osteoarthritis or rheumatoid arthritis
  • gout
  • other conditions such as cerebral palsy and Marfan syndrome
  • wearing badly fitting shoes

Pain and stiffness in the big toe, and an angular, bony bump on the side of the foot are the key symptoms of bunions.

 

Bunions will cause pain and stiffness in the joint at the base of the big toe when you walk or stand.

You’ll find it difficult to run or squat and there will probably be swelling and inflammation around the joint. A hard angular bump on the side of the foot at the base of the big toe may be covered with hardened skin or a callus.

You may also experience unusual tenderness at the base of the big toe and in the ball of the foot, and the area can become shiny and warm.

Symptom can include:

  • big toe points inwards towards other toes
  • foot becomes wider so shoes may not fit
  • painful to walk
  • inflammation and swelling at the base of the big toe
  • bony bump on the outside edge of your foot
  • hard, callused, red skin where toes overlap
  • sore skin over the bunion

Your doctor should be able to diagnose bunions based on the pain you’re experiencing and the shape of your toe. However you may be referred for further tests, including x-rays, to determine the severity of your condition. Blood tests may also be recommended to investigate whether arthritis could be causing your pain.

Based on the results of these tests, a course of treatment can be recommended.

Bunionectomy - treatment of hallux valgus deformity (bunion)

A chevron osteotomy is a type of surgery that is used in the treatment of hallux valgus deformity, more commonly known as a bunion.

Bunion removal - Scarf/Akin osteotomy

Bunion surgery is carried out to correct a deformity at the base of the big toe. It may involve removing parts of bones and realigning them to straighten the toe.

Chevron Osteotomy

A chevron osteotomy is surgery carried out to correct a deformity at the base of the big toe such as a bunion. It involves removing parts of bones and realigning them to straighten the toe.