How to Assess the Severity of a Bunion

An assessment of the severity of a bunion (hallux valgus), whether by a physician or yourself, is necessary prior to properly treating it. Continued assessment also helps in evaluating whether conservative treatments are successfully straightening the toe. Until recently, only physicians used the Manchester scale to measure the medial deviation of the metatarsophalangeal (MTP) joint with respect to the big toe. However, according to a 2010 study, the accuracy of patients using the scale to self-assess bunion severity is acceptable.

Things You'll Need

• Printer
• 4 to 8 pieces of 8 1/2" x 11" paper
• Pen

Show More

Instructions

• 1

  Print each standardized photograph of the four grades of hallux valgus for either the right or left foot, or both feet (see Reference 2).

• 2

  Place each image next to the misaligned toe or toes and identify which of the four grades most closely correlates with the positioning. Mark with an "X."

• 3

  Focus your efforts on maintaining healthy feet if you placed an "X" on "No Deformity=0." Avoid improperly fitting shoes, including pointed-toe shoes and heels greater than one-and-a-half inches. Stretch the tendons and strengthen the muscle ligaments by stretching and exercising the foot daily. Avoid development of excessive pronation in the feet (fallen arches or flat feet) by being aware of good posture and balanced alignment of the pelvis and knees.

• 4

  Maintain healthy feet and prevent further progression of the deformity if you placed an "X" on either "Mild Deformity=1" or "Moderate Deformity=2." As with all stages of a bunion, wear wide toe-boxed shoes with proper support. Stretch the tendons and strengthen the muscle ligaments by stretching and exercising the foot daily. Ideally, wear a bunion splint that stabilizes the metatarsal arch and pulls the big toe away from the smaller toes while walking, so the correction of the bunion occurs through the range of motion.

• 5

  Consult a medical professional prior to using a bunion splint if you placed an "X" on "Advanced Deformity=3." In the meantime, wear wide toe-boxed shoes with proper support, and wear a mid-foot arch support or brace, in order to stabilize the metatarsal bones and take pressure away from the painful bunion while wearing shoes.

• 6

  Repeat this assessment after six to eight weeks of daily treatment to measure whether the medial deviation has lessened. If so, congratulations and continue the non-surgical treatment. If there is no improvement, consult a medical physician for further advice.