Hallux Valgus (Bunion)

The term “hallux valgus”—commonly known as a bunion—describes perhaps the most common deformity of the foot. It affects a large portion of the population and is a progressive condition in which the first metatarsophalangeal (MTP) joint is initially involved, eventually affecting the entire foot. It occurs more frequently in women, although men may also develop the condition over time. Indicatively, 1 in 3 women will develop this deformity at some stage in their lives.

Indeed, hallux valgus can significantly affect a patient’s quality of life, as it is often accompanied by functional impairment and foot pain. However, some patients may never experience pain or restriction of movement. Depending on the severity of symptoms, a bunion may be treated either conservatively or surgically. Time is an important factor, meaning that patients should seek medical advice before their symptoms worsen.

A bunion is a visible bony prominence that forms on the inner side of the big toe and is accompanied by deviation of the big toe toward the center of the foot. This deformity develops after years of pressure on the big toe joint and is usually related to hereditary factors or previous injuries. Over time, the joint becomes misaligned, gait is altered, and load distribution to the knee and hip is affected. The medical term for a bunion is hallux valgus. This condition occurs mainly in adults and more commonly in older women. However, it can also appear in children or adolescents, even before skeletal growth has been completed. A bunion may develop in one foot, but it most commonly affects both feet. The right foot often shows greater deformity, as it typically bears more pressure between the two.

The degree of severity depends on the progression of the condition. In some cases, the big toe shifts toward the neighboring toes, significantly impairing walking. In more advanced stages, the big toe may even overlap the adjacent toes, making it difficult or impossible for the patient to wear regular footwear or walk comfortably without support. Patients with bunions often experience temporary relief with ice therapy; however, the deformity itself cannot be corrected without medical intervention.

Although prolonged standing and the long-term use of high-heeled shoes or footwear with a narrow or poor fit may aggravate the condition, they are not the primary cause of hallux valgus. The main underlying cause is heredity. It has been reported that even individuals from various populations who have never worn shoes in their lives may still develop severe hallux valgus (bunion) deformities. A bunion forms gradually and progressively worsens over time if left untreated.

Individuals who are at greater risk of developing the condition include those who:

• Have a family history due to inherited structural foot abnormalities (such as flat feet)
• Have sustained foot injuries
• Suffer from inflammatory diseases, such as rheumatoid arthritis
• Have parents with bunions

The altered appearance of the foot and increasing pain are the main symptoms of the condition. However, the rate at which it progresses is unpredictable. The most common reason patients seek medical attention is pain, both in the big toe and in the adjacent toes. The most noticeable sign that a patient is suffering from hallux valgus is the prominent bony protrusion that develops at the joint of the big toe.

• A bony prominence on the inner side at the base of the big toe
• Swelling, redness, or pain around the big toe joint
• Calluses where the first and second toes rub against each other
• Persistent pain or pain that comes and goes
• Limited movement or numbness of the big toe
• Difficulty fitting into shoes
• Problems with walking

Although a bunion often does not require urgent medical care, the patient should definitely consult a specialized orthopedic surgeon if:

• They suffer from persistent pain in the big toe or foot
• They suffer from persistent pain in the big toe or foot
• They experience problems with the movement of the toe or foot

The diagnosis is made through a physical examination, while an X-ray helps determine whether there is joint damage or misalignment of the bones. There are various treatment options available. The specialized physician will decide on the most appropriate treatment approach based on the severity of the symptoms and the patient’s medical history.

Restoring painless walking is the primary goal for patients with a bunion. Properly fitting shoes, as well as custom-made orthotic insoles, are key to preventing the progression of this condition. In contrast, narrow shoes and high heels can worsen the deformity by placing excessive pressure on the toe throughout the day. A bunion does not resolve on its own without surgical intervention. However, conservative treatment is often sufficient, especially in the early stages. It focuses on relieving symptoms and may include:

• Silicone toe spacers are placed between the toes to reduce pain and help maintain proper alignment
• Use of orthopedic footwear
• Physiotherapy
• Elevation of the feet for at least 20 minutes per day
• Ice therapy
• Analgesics and anti-inflammatory medications
• Custom-made insoles to improve weight distribution

Proper foot support during walking, through the use of orthopedic insoles and shoes that provide adequate space for the toes, is considered ideal for preventing further deterioration and gradually improving gait. If the patient wishes to wear more restrictive or fashionable footwear on certain occasions, it is advisable afterward to rest and elevate the feet to reduce any swelling or discomfort. It is important to carefully evaluate all conservative treatment options to determine which approach provides the greatest relief for the patient. Additionally, any ongoing medication should be reviewed to ensure that it does not interfere with the treatment plan or negatively affect bone health.

If non-surgical treatments do not provide relief and walking becomes extremely painful, the specialized physician may recommend surgical intervention. During the procedure, the orthopedic surgeon removes the bunion and realigns the bones to restore the big toe to its proper anatomical position. The surgeon’s expertise is of critical importance, as selecting the appropriate modern surgical technique plays a decisive role not only in the success of the treatment but also in the speed and overall quality of recovery. By choosing a highly specialized orthopedic surgeon, the patient can feel confident that the deformity will be effectively corrected, the likelihood of recurrence will be minimized, and the overall quality of walking and foot function will improve significantly.

The procedure is completely safe and ensures reduced postoperative pain, as well as rapid mobilization. In most cases, the patient can walk on the same day of surgery and return to daily activities within approximately 2 to 3 weeks, depending on the type of procedure performed. Initially, walking is supported with the use of a special open postoperative shoe. In the following days, the patient can gradually return to wearing regular footwear of their choice. A widely held myth that is not true claims that bunion correction surgery results in severe pain and a difficult recovery. This misconception is based on older surgical techniques, which involved the use of pins and prolonged immobilization of the foot in a cast or splint. Modern surgical methods are significantly safer, less invasive, and far less painful. Today, a structured program of specialized strengthening exercises, combined with anti-inflammatory medications and analgesics, helps patients return quickly to their normal daily activities, including walking, driving, and sports. Experienced and specialized orthopedic surgeons can provide patients with individualized guidance and a tailored treatment plan, regardless of the stage of the deformity. Dr. K. Dretakis performs a large number of specialized foot surgeries each year at Hygeia Hospital, ensuring optimal surgical outcomes and a smooth recovery process for his patients.

The price and overall cost of the surgery vary depending on the severity and specific characteristics of each case. To receive accurate information regarding the exact cost of the operation, we recommend that you contact us directly. This will allow us to properly assess your case and jointly determine a treatment plan that best suits both your medical needs and your financial capabilities. Dr. K. Dretakis and his experienced team will guide you appropriately, creating a personalized and comprehensive management plan tailored specifically to you.