Bunions 
Hallux Limitus and Bunions
For
Information on Bunion Surgery Click here.
If you have pain in the big toe joint you are likely experiencing one of
two related conditions—Hallux Limitus or Bunion. When humans walk,
during the last part of a step, just before the foot comes off the
ground, the big toe joint should bend up about 75 degrees. If this
natural motion is not allowed, pain and deformity can develop.
Some people have a foot that rolls inward - or “over-pronates” - too
much as they walk. When the foot over-pronates, the big toe joint is
pushed into the ground. This prevents the big toe joint from bending
naturally during the step.
What Causes Pain in the Big Toe Joint?
When the big toe cannot bend upward, excessive force builds up inside
the joint each time that you take a step. This joint “jamming” can
cause pain in the joint and over time lead joint damage such as
arthritis. This pain and damage is called Hallux Limitus.
People with Hallux Limitus will have pain in the joint when they walk
and sometimes after activity. It can be worse in some shoes than in
others. There may or may not be visible signs of changes to the joint
and a bunion may or may not be present.
Pain in the big toe joint, even if there is no visible sign of
change, is an indication that there is damage occurring to the joint.
This warning sign should not be ignored. Hallux Limitus is a
progressive deformity and early treatment can help prevent future
problems.
What is a Bunion?
In some feet with Hallux Limitus, the first toe starts to move toward
the second toe as a means of relieving the excessive force within the
joint. This causes an angulation of the toe to the metatarsal bone and
the appearance of a bump on the big toe joint. This combination of
angulation of the toes and the bump on the outside of the joint is what
is commonly known as a bunion deformity. The deformity is also known as
Hallux Abducto Valgus or HAV.
The deformity does run in families; however, the foot type is
hereditary, not the bunion. Shoes do not usually cause bunions,
although the wrong shoes can make the deformity more painful.
HAV is a progressive deformity. Treatment can slow or stop the
progression in many cases and help prevent joint damage or the need for
surgery.
Treatment
Hallux Limitus and HAV treatment varies depending on your foot type,
severity of the deformity, your activities and your symptoms.
Evaluation should be sought at the first sign of a bunion condition, so
severe deformity and arthritic changes can be avoided.
Early Treatment
The primary purpose of early treatment is to relieve pressure within the
big toe joint and to diminish the progression of joint damage. The main
conservative therapies include:
- Functional orthotics; prescribed and cast by your doctor and
designed to relieve pressure within the big toe joint
- Shoe Therapy; including proper shoes for your foot type and
activities and possible modifications to your shoes
- Accommodative Padding
Custom Orthotics and Big Toe Problems
(For more information on orthotics)
If you do not have significant deformity or joint damage, custom
functional orthotics are useful in controlling abnormal foot mechanics
and preventing the need for surgery.
Orthotics for big toe joint problems are prescribed specifically to
help decompress the big toe joint and help it work in a way that
decreases the chance of joint damage. In order to ensure best outcomes
we first perform a detailed examination, including slow motion video
analysis, of how you walk and how your big toe joint works. A mold of
your foot is then taken in a very specific position and the orthotic
devices are prescribed in a manner to best protect the joints.
Hallux Limitus and HAV are progressive deformities and will get worse
over time if not treated correctly. The correct orthotic can help
decrease pain and possibly prevent progression.
When is Bunion or Big Toe Joint Surgery Needed?
For
Information on Bunion Surgery Click here.
When you start to have joint pain or the bunion condition limits your
activities and all conservative options have failed, surgery may be
necessary. Joint pain may indicate degeneration of the joint cartilage.
One of the goals in surgery is to realign the joint to prevent further
loss of joint cartilage.
Pain and deformity are significantly reduced in the great majority of
patients who undergo bunion surgery. Bunion surgery allows for
realignment of the joint. After surgery the foot should be able to carry
the body’s weight in a more normal fashion and special shoes should no
longer be required. Postoperative orthoses may be recommended to improve
foot function and limit excessive forces through the great toe joint.
Don’t let your bunions or big toe pain get worse. Early treatment can
prevent future problems. Call today for
an appointment in our Seattle office.
All pages on this website © 2008
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.
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