Foot / Big Toe pain and Dysfunction (Bunion pain). Gosforth Physio & Wellness Newcastle.
Hallux valgus, is more commonly known as a bunion, it is a deformity of the big toe. The big toe (hallux) rolls inwards to the toes causing a bony (sometimes very painful) lump to be created on the medial (inside) of our foot. The patient may report increased pain on weight-bearing, walking, hot, swollen joint, reduced balance and gait (walking) function. They may also report a medial bunion that has been evident for some time. It is seen clinically more in females than males and is increased in people over 50 years old. If a bunion has developed it is commonly back, hip or knee pain that the patient might present with, this may have been gradually building for weeks, months or years!
Pathological Process (how it happens) Altered foot biomechanics leads to altered muscle function. Eventually the extensor hallux longus (big toe extensor), flexor hallux longus (big toe flexor) and the big toe adductor (in) and abductor (out) muscles of the great toe shift laterally displacing the joint and further accentuate the deformity. Bursa (fluid filled sack / shock absorber) over the medial aspect of the metatarsal head may become inflamed and the bone hypertrophies (increases in size) leading to a painful bunion.
The development of hallux valgus appears to occur secondary to combination of intrinsic and extrinsic causes. Causative factors include: Biomechanical – excessive pronation (flat foot) leading to increased pressure on the medial border of the hallux,(big toe) results in deformation of the medial capsular structures. Other conditions that may be causative are Gout, Rheumatoid arthritis, MS (multiple sclerosis) and / or connective tissue disorders, i.e downs syndrome.
You can take very quick and safe steps to prevent or alleviate most bunion pain. Physiotherapists and Podiatrists at Gosforth Physio & Wellness are highly skilled experts in diagnosis, treatment, education and prevention of bunion pain. Early diagnosis and treatment is essential to aid speedy recovery from bunion pain and help prevent its recurrence.
We use our head before we use our hands! At Gosforth Physiotherapy & Wellness we are the specialists in assessment, diagnosis, treatment and education of pain and dysfunction from neuro- musculoskeletal foot conditions. You can be assured that you’re placing your health in the right hands. Once a detailed assessment is completed and we have established your diagnosis all appropriate treatment options will be discussed with you.
Manual therapy to help distraction of the painful joint to help reduce pain and increase synovial fluid (nutrition) production of the joint. Strengthening exercises to help maintain the strength and mobility of the toe and foot. Acupuncture can be useful in reducing both pain and inflammation for bunion pain. NSAIDS (ibuprofen) advice which can prove useful in reducing symptoms, however, long term use must be discussed with your GP.
Podiatry / Biomechanical assessment
A podiatry assessment in order to ascertain the correct prescription for a bespoke orthotic to correct the biomechanical changes, therefore providing support and aiding the motion of the big toe and foot. This is very useful in the ongoing management of a degenerative condition. Advice and use of toe spacers and / or wider footwear to reduce friction and inflammation of the joint is available from the podiatry team.
Our injection therapist can advise you on corticosteroid injections to help reduce both short and long term symptoms. If none of the above works then finally surgery including Wilson / Mitchell’s osteomies can be discussed with an orthopaedic consultant that we can arrange through your GP.
It is very rare that an MRI scan or X Ray is required.
However, if your Physiotherapist or you feel that further investigation is necessary we can arrange private scans quickly. Referrals can be arranged in 2-5 days at The Newcastle Clinic and at North Tyneside MRI Centre.
Please call to book an appointment with our specialised physiotherapy and podiatry team for an assessment.