A bunion, or hallux abducto valgus, is a bulge that appears on the inside of the forefoot at the base of the big toe. As the big toe deviates towards the lesser toes (outwards) and the first metatarsal bone deviates medially (inwards). It is generally a progressive condition meaning that it becomes worse over time and may eventually cause the other toes to overlap one another. In its early stages the condition is relatively painless but as the deformity worsens pain is likely to occur.
Bunions are caused by biomechanical stresses placed on the toe in such a way that it alters the alignment of the joint over time. They are made worse by wearing ill-fitting shoes, high heels (because they compress and squash up your toes), arthritic conditions and traumatic toe injuries. Bunions tend to run in families so taking a look at your parent’s feet can often be a window into the future!
Podiatrists can generally diagnose a bunion following a thorough clinical assessment. X-rays may be required to determine the level of deformity of the joint.
How to treat Bunion's
Our approach to the treatment of bunions is firstly to reduce symptoms and then to slow the progression (stop it from getting worse).
Treatment options include:
– Making changes to footwear. Supportive shoes with a wide toe area to avoid any compressive forces on the toes.
– Strengthening and stretching exercises to help with stability of the big toe joint and surrounding structures.
– Interdigital wedges to reduce pressure on adjacent toes.
– Orthotics to improve foot position and reduce bunion-forming-forces that are contributing to malalignment of the toe
While it is possible to slow the formation of a bunion using the above treatment options, unfortunately, once a bunion has formed the only method by which to correct it is surgery. Our podiatrists have an excellent working relationship with podiatric and orthopaedic surgeons in the area and can refer you on if this is an option you would like to explore.
A family history increases the risk of developing a bunion however it is important to recognise that there are other factors at play. Biomechanical factors such as increased force through the big toe joint, flat feet, poor footwear choices, traumatic injury and certain activities such as ballet dancing may contribute to the severity of a bunion.
The deviation of the big toe may not only cause pain in this joint but can also affect the alignment of the rest of the foot. It can cause compensatory symptoms within the plantar fascia and other soft tissue structures. Bunions may also cause a number of issues with the lesser toes as they become more cramped for space. This can result in the development of hammer toes, clawed toes, painful corns and callus as well as toes overriding one another.