From the Research
Yes, a hypermobile first metatarsophalangeal (MTP) joint can be the sole cause of a bunion, also known as hallux valgus. When the first MTP joint is excessively mobile, it allows the first metatarsal bone to drift medially while the big toe deviates laterally, creating the characteristic bunion deformity. This hypermobility often results from ligamentous laxity or instability in the joint.
Key Points to Consider
- Treatment for a hypermobility-induced bunion typically begins with conservative measures such as proper footwear with a wide toe box, orthotic devices to stabilize the joint, toe spacers, and physical therapy exercises to strengthen surrounding muscles 1.
- For severe cases that don't respond to conservative treatment, surgical intervention may be necessary to stabilize the joint and correct the deformity, as discussed in the management of bunions 2.
- The specific surgical approach would depend on the severity of the deformity and may include procedures to realign the bone, tighten the joint capsule, or fuse the joint.
- Hypermobility as a cause of bunions is particularly important to identify because treatment should focus on stabilizing the joint rather than just addressing the visible bump.
Importance of Identifying Hypermobility
Identifying hypermobility as the cause of a bunion is crucial for effective treatment, as it requires a different approach than other causes of bunions.
- Generalized joint hypermobility can be easily assessed using a standardized, quick, in-office examination, and management is relatively straightforward once joint hypermobility is recognized using neuromuscular re-training 3.
- Braces and splints can also be used to immobilize and protect joints, reduce pain, decrease swelling, and facilitate healing of acute injuries, and may be used in the treatment of bunions 4.
- However, the most recent and highest quality study on the topic of bunions, published in 2020, provides the most relevant guidance on the management of bunions, including those caused by hypermobility 2.