Nursing Notes

Bunion (hallux valgus deformity)

Bunion (hallux valgus deformity) is an enlargement inside the foot that involves the big toe joint. It appears as a bony bump at the outer side of the big toe, while other times on top of the smallest toe (bunionette). It is a misalignment of the big toe joint (metatarsal phalangeal joint) that causes the big toe’s positioning to point outward, towards the adjacent smaller toes.


There is no exact cause for bunion. However, this deformity seems to be hereditary affecting more women than men.

Signs and symptoms

*Enlarged sides of the big toe on both feet
*Pain when walking, especially with footwear
*Redness, tenderness, swelling, and pain on the bump
*Pain is relieved upon rest

Diagnosis is possible when the signs and symptoms mentioned above are present. An X-ray of the foot can be helpful to know extent of the deformity.


Bunion can’t be prevented but the progression can be slowed down with early diagnosis, in preadolescence, along with proper supportive treatment such as orthotics and suitable footwear.


Non-surgical management −This can relieve pain and discomfort but cannot correct the deformity.

1) Suitable footwear
-Wear flat or low-heeled footwear to evenly spread pressure throughout the foot
-Wear shoes that have a wide toe box or that leaves the toe exposed to reduce pressure on the bunion.

2.) Pain Reliever
-Take anti-inflammatory drugs like ibuprofen, aspirin, and naproxen to reduce
inflammation and to relieve pain.
– Paracetamol can also be used to relieve pain.

3.) Apply cold compress
– Place an ice wrapped in cloth on the bunion several times a day to numb the
area and reduce swelling.

4.) Bunion pads
– A bunion pad, made of gel/ fleece, protects the bunion from getting rubbed on
the shoes.

5.) Injection
– Cortisone local injection helps alleviate pain and inflammation on the joint.

6.) Devices
– Toe Spacers- helps relieve pain
-Bunion Splints- helps realign bones of the feet
-Orthotics- worn inside the shoes to help realign bones of feet & to relieve pain.

Surgical Procedure – This is a last resort for those experiencing significant foot pain.
-Bunion surgery success rate is only up to 85% with no guarantees the
foot will be straight nor pain-free.
-The toe will be stiff and flexibility will be limited after surgery.

So, consult your doctor or surgeon before deciding to take the surgery as other important factors still need to be considered.

Sources: Klippel, John H., eds., et al. Primer on the Rheumatic Diseases, 13th ed. New York: Springer, 2008.

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