The precise cause is not fully understood but there are many proposed theories. This deformity is most likely a result of multiple contributing factors

• Genetics

• Structural anatomy such as: short first metatarsal, dorsiflexed first metatarsal, rigid or flexible pes planovalgus (flat foot)

• Abnormal foot mechanics

• Joint hypermobility

• Arthritic conditions : gout, psoriatic arthritis, and rheumatoid arthritis

• Connective tissue conditions Marfan syndrome and Ehlers-Danlos syndrome

• Shoe gear influences

• Traumas

Symptoms include:

• Medial Eminence or Visible Bump: on the outside of the big toe joint.

• Pain & Tenderness, aching, or sharp pain in the joint, especially with activity or pressure.

• Inflammation: Redness, swelling, and warmth around the joint.

• Skin Changes: Thick skin (corns/calluses) on the bump or between toes where they rub.

• Toe Alignment: The big toe points inward towards the second toe.

• Stiffness & Limited Motion: Difficulty bending or moving the big toe.

• Walking Discomfort: Pain or difficulty when walking or wearing shoes. 

Conservative Treatment

• Shoe modification: Low-heeled, wide shoes.

• Orthoses: Improves alignment and support.

• Medication: Acetaminophen and NSAIDs.

• Injection therapy

• Ice

• Taping/Padding/ Bunion splint

• Stretching: Helps maintain joint mobility in the affected joint.

• Strengthening of the intrinsic foot muscles

Surgical treatment: Failure of conservative, and is primarily based on symptoms

• Open repair Osteotomy (Hallux and or First metatarsal)

• Minimally Invasive Techniques

• Arthrodesis

• Arthroplasty

• Soft tissue procedures