Hallux vagus

Borders Ref Help Toolkit
NHS Borders

Hallux Valgus (Bunions) - A deformity where the 1st metatarsal deviates medially and the Hallux deviates towards the 2nd toe. Females are 9 times more likely to present with the condition than males. 23% of 18-25 year old’s and 35% of over 65’s develop bunions. Not all bunions become painful. Pressure from footwear can cause increasing pain and deformity, and sometimes will cause a bursa will form which can be inflamed and painful. In some instances, the joint can develop arthritic change and become painful.

Who to refer, who not to refer, how to refer

Who to refer:

  • Anyone regardless of age with pain from the big toe joints can be referred if self-management measures have failed.

Who not to refer:

  • Patients who are undergoing ongoing management for this condition with another service.

How to Refer:

Refer via SCI Gateway or ask patient to complete self-referral form here: podiatry-self-referral.docx (live.com)

Primary care management

General Advice

  • Provide patient leaflet – Hallux Valgus: Information for Patients
  • Activity modification (as required)
  • Pain management
  • Advice on footwear – flat, wide-fitting shoes with room for the toes should be worn
  • Advice on trying gel/silicon toe separators from pharmacy or online if pressure from the 1st toe is causing pain elsewhere
  • If pain is from rubbing on footwear provide advice on bunion protectors which can be bought from a pharmacy or online, these can reduce rubbing on the skin and reduce pain.  (Ensure patients are aware these are for pressure/rubbing relief only and are not a cure for bunions)

Resources and links

National and local websites for further information

For patients:

NHS Borders Hallux Valgus information leaflet: Hallux Valgus: Information for Patients

Self-referral form for NHS Borders Podiatry: podiatry-self-referral.docx

Footwear advice leaflet – includes information on companies who provide wider fitting footwear options: Guide to buying footwear.docx

Local service details

Podiatryadmin@borders.scot.nhs.uk

Editorial Information

Last reviewed: 20/05/2024

Next review date: 20/05/2026

Author(s): Laura Bolan.

Author email(s): laura.bolan3@nhs.scot.