Hallux Valgus (Bunion) — When the Big Toe Bends Outward
Table of Contents
What is hallux valgus?
Hallux valgus (bunion) is a foot condition in which the big toe tilts toward the second toe by more than 15 degrees, and the head of the first metatarsal protrudes medially, causing pain and deformity. When the protruding area rubs against shoes, bursitis develops, leading to redness, swelling, and warmth. It is roughly 10 times more common in women.
Causes and risk factors
The greatest external factor is long-term wearing of narrow, pointed-toe shoes. High heels concentrate body weight on the forefoot and push the big toe outward. Genetic predisposition (flat feet, joint hyperlaxity) and rheumatoid arthritis are also major internal factors. In Korean medicine, this is interpreted as stagnation of qi and blood in the Liver meridian, which settles around the big toe and drives deformity and pain.
Metatarsalgia and chain reactions
When the function of the big toe declines, body weight shifts to the heads of the second and third metatarsals during walking, producing transfer metatarsalgia. Abnormal pressure on the sesamoid bones beneath the big toe can also lead to sesamoiditis. It is not uncommon for the toe deformity to alter gait and extend pain to the knees and lower back.
Conservative treatment — Korean medicine approach
- Acupuncture: Liver meridian points such as Taichong (LR3), Xingjian (LR2), and Dadun (LR1), along with ashi points around the protrusion, are needled to reduce local inflammation and pain.
- Pharmacopuncture: When bursitis is present, anti-inflammatory pharmacopuncture is used to relieve swelling.
- Chuna manipulation: Releases adhesions of the medial capsule of the first metatarsophalangeal (MTP) joint and restores the function of the abductor hallucis.
Orthoses, insoles, and shoe choice
A night splint guides the big toe medially overnight, and a silicone toe spreader is worn during the day. Custom insoles that support the arch and distribute forefoot pressure significantly reduce pain. Choose shoes with a sufficiently wide toe box and heel height of 3 cm or less. Surgery is considered when the deformity exceeds 40 degrees or when conservative treatment fails to respond.