Bunions: What we can do about them

July 22, 2016 17:33
High heels may look good but they can also damage your feet. Photo: Reuters

A bunion, medically known as hallux valgus, is a deformity of the joint at the base of the big toe. While the problem could arise due to several reasons, it is recognized that the most susceptible victims are those who wear ill-fitting shoes over a prolonged period.

Nearly 70 percent of the patients are females and one in four women patients are diagnosed between the age of 30 and 40.

This is not surprising given the love that many women have for high-heeled shoes.

Though hallux valgus is not life-threatening, it deteriorates the quality of life of the patient by causing pain, discomfort and walking problems. 

The exact cause of it is unknown, but it tends to run in families. It is also likely to occur in people with unusually flexible joints or flat feet, or patients with rheumatoid arthritis and gout.

Wearing high-heels, pointed shoes or any other poorly fitting shoes, meanwhile, might increase pressure on the forefoot, making the condition worse.

Apart from making the appearance of feet bad, untreated hallux valgus could lead to further problems.

As the big toe is pointing towards the others, it could force the foot bone attached to it (the first metatarsal bone) to stick outwards, causing pain and swelling over the joint. The overlapping between the big toe and the second toe would also create hard and callused skin that would cause further pain.

Common non-surgical treatments for bunions include physiotherapy and use of artificial devices such as bunion splints and toe spacers. But these can only relieve the pain and are not so effective in the long run.

Bunion surgery is the only way to correct and fix the alignment of the big toe. Traditionally it involves procedures of breaking and shifting of bones, and fixing the new break with pins, screws, or plates. It would take months or longer for the affected bones and soft tissues to be healed.

Since the year 2000, the North District Hospital has been introducing endoscopic-assisted correction of hallux valgus deformity. The procedure constitutes a minimally invasive surgery involving five small cuts of less than 5 millimeters wide.

Patients who have received the surgery have reported that the pain has eased to level one or none from level 6 before the correction. The risk of surgical complications has also been significantly lowered, compared to the traditional intervention.

Nonetheless, prevention is always better than cure, and there are many ways to ensuring healthy feet. Here are four things that you can do: 
1. Wear comfortably wide shoes than pointy ones to reduce the pressure on the forefoot.
2. Avoid high-heeled shoes.
3. Do some simple foot exercises and stretches to reduce the internal tension.
4. Rest legs and feet so as to reduce fatigue.

Dr. Samuel Ling Ka-kin, specialist from the Department of Orthopaedic and Traumatology of North District Hospital, is the co-author of this article, which appeared in the Hong Kong Economic Journal on July 20.

Translation by Darlie Yiu

[Chinese version 中文版]

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Dr. Lui Tun-hing is a consultant from the Department of Orthopaedic and Traumatology of North District Hospital.