The Humble Bunion, or Hallux Abducto Valgus

A bunion is a progressive disorder. It begins with a leaning of the big toe towards the second toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes more and more prominent. The tissues over the bump can become inflamed – red, sore, warm, and tender – and calloused.  And further deformities can occur, e.g. hammer toe or claw toe.  Scientists have examined the prevalence of bunions and factors associated with their occurrence, and assessed the severity of the deformity in an older adult population in the UK. Their findings have been reported in Arthritis Care and Research.

There were 2800 participants aged 56 or older from the North Staffordshire osteoarthritis project. They were asked to estimate the degree of deformity if they had bunions, with one representing no angle and five indicating the most severe deformity (60° deviation towards the second toe).

More than a third of the collective had some degree of deformity. It was greater in women and increased with age. In those with pain in the last 12 months, those with money and deformity had higher scores in both pain and impaired function.

Bunion deformity was found to be significantly associated with reduced physical function, generalized body pain, general health, social function, and mental health. Other studies have shown that tight shoes and hours spent standing or walking are likely to exacerbate deformity and pain. The study above also included a quality-of-life survey that showed the problems associated with bunions affect more than the great toe. Fortunately, there are a number of treatments, but an orthopedic surgeon will probably tell you that only open surgery will guarantee a cure.