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Bunion, Valgus Hallux and Physiotherapy

A bunion is the enlargement of the joint at the base of the big toe, which causes the big toe to bend towards the other toes as the joint becomes larger.

Can it be painful? Yes, patients often report pain, and unfortunately many patients develop arthritis of the joint as the joint continues to stiffen and tighten over time.

Bunion symptoms

The classic tell-tale sign is the big toe will start to deviate and point towards the other toes on the same feet plus stiffening of the joint of the big toe.

At the early stages, there’s little to no pain, but as the bunion worsens, the bump gets bigger and the big toe will deviate more and more, with more and more pain from the pressure inside the joint.

Patients will find it increasingly difficult to get footwear, plus they can also get corns on the enlarged joint and the 2nd toe cos of the deviation.

What causes bunions?

The main cause is the force imbalance that’s exerted in the toes and foot during walking that causes the joint instability.

It’s due to

  1. inherited genes / genetic factors
  2. physical damage
  3. neurological damage

Bunions can be aggravated by long term wearing of tight-fitting shoes or sandals.

Physiotherapy treatments for bunions

  1. We will need to assess to identify any imbalance within the foot
  2. Find out if there’s aggravating factors
  3. Correct imbalances and remove those aggravating factors
  4. Failing which, if the condition worsens, then patient may require corrective surgery

Our immediate goals are firstly pain relief, so that patient can move about with less pains and discomfort. We do this by relieving the pressure on the bunion.

The close second goal is to quickly and effectively decrease the worsening of the bunion deviation.

Thirdly to improve the range of motion and also prescribe bunion correctors or orthotics.

We can start with some heat therapy such as

to relax stiffness and soften the joints, before starting gentle mobilization to loosen the affected joints. When the toe is ready, we can do active strengthening and range of motion to strengthen the muscles in the foot that can help correct the alignment.

Where To Next?

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