Hallux valgus – the bunion

A hallux valgus, commonly known as a bunion, is a deformity of the big toe. It may initially be barely noticeable, but later can cause pressure points and discomfort – especially when wearing shoes. It is therefore crucial to understand the changes in the foot and to ensure sufficient space and a suitable width when choosing shoes.

What is hallux valgus?

In hallux valgus, the big toe deviates towards the other toes. At the same time, the first metatarsal bone shifts towards the inside of the foot. This creates the characteristic bony protrusion at the big toe joint, which can become visible as a "bunion".

How pronounced the deformity is and whether it causes discomfort can vary greatly from person to person. Some people only notice the altered position of the big toe for a long time. In others, pressure sensitivity, skin irritation, or pain may arise with prolonged walking and standing. Problems with shoe selection are also typical.

Hallux valgus is not to be equated with hallux rigidus. In hallux rigidus, the increasing restriction of movement of the big toe joint due to wear and tear is primarily in the foreground.

How does a bunion develop?

The development of hallux valgus usually cannot be attributed to a single cause. A familial predisposition can play a role. In addition, increased ligament mobility, muscular factors, and coexisting foot deformities such as splayfoot or flatfoot are discussed. Women are more often affected than men.

The earlier idea that unsuitable shoes alone cause hallux valgus is therefore too simplistic. The shoe shape can still be important for people with a corresponding foot shape or existing deformity: a narrow forefoot area or a high heel can exert additional pressure on the bunion and toes, making shoes more uncomfortable to wear.

A splayfoot can occur together with a hallux valgus but is not present in every affected person. The two foot changes should therefore be considered separately.

What discomfort can hallux valgus cause?

Not every hallux valgus automatically causes pain. Discomfort often arises where the protruding bunion comes into contact with the shoe. Friction and pressure can irritate the skin and make the big toe joint sensitive.

With more pronounced changes, the adjacent toes can also be affected. The big toe can increasingly move towards them, changing the space conditions in the forefoot.

If new or stronger pain occurs, the deformity significantly increases, or walking is impaired, an orthopedic evaluation is advisable.

What can be done about hallux valgus?

Conservative measures can primarily aim to reduce discomfort. Depending on the individual findings, these may include, for example, adjusting footwear, orthopedic aids, and physiotherapeutic measures. However, an existing bony deformity cannot usually be permanently corrected by such measures.

Which measures are useful depends on the extent of the deformity and the existing discomfort. A medical evaluation is therefore particularly advisable if pain persists or mobility is restricted.

Which shoes are suitable for hallux valgus?

Shoes for hallux valgus should above all offer sufficient space for the forefoot and, if possible, not exert additional pressure on the bunion. Not only the shoe size but also the appropriate shoe width is important here.

When selecting, you can pay particular attention to the following features:

• sufficient space for the big toe and forefoot
• a shoe width that fits the foot
• soft and adaptable upper material
• preferably no pressing seams or firm edges in the bunion area
• a secure fit so that the foot does not slide forward into the shoe
• a low to moderate heel

How much width is actually needed is individual. Not everyone with a hallux valgus automatically needs a particularly wide shoe. It is therefore helpful to first familiarize yourself with the different [shoe widths explained]. If the forefoot needs significantly more space, [extra wide shoes] can also be an option.

Why is sufficient space important for sensitive feet?

A shoe should hold the foot without constricting it. Especially with a pronounced bunion, a too narrow shoe can press laterally on the big toe joint. More space in the forefoot and a yielding upper material can help to avoid such pressure points.

High-quality, soft leather can adapt to the individual foot shape during wear. However, it remains crucial that the shoe already offers sufficient space when trying it on. Relying on a significantly too tight shoe to stretch enough later is not advisable.

Those with particularly pressure-sensitive feet can find further tips on choosing suitable shoes under [shoes for sensitive feet].

If individually adapted insoles are worn, a [removable footbed] can also be practical. Whether insoles are medically advisable for hallux valgus, however, should be discussed individually with the treating physician or an orthopedic specialist.

Hallux valgus: Good fit relieves the foot in everyday life

Hallux valgus is a complex deformity whose development is influenced by various factors. Shoes cannot cure the cause, but they can be crucial for how comfortable the foot feels in everyday life.

Therefore, pay attention to enough space in the forefoot, a suitable width, soft materials, and a secure fit. Especially with sensitive feet, it is worthwhile not to choose shoes solely according to the stated size, but to pay attention to how well they fit the actual shape of the foot.