Bunions

A bunion is generally considered an enlargement of the joint at the base and side of the big toe. 

Bunions can also be referred to as Hallux abducto valgus: the big toe (hallux) moves away from the centre of the body and the toe itself twists slightly (abducto valgus). 

Causes 

There are endless causes of bunions. These factors may increase your risk of developing bunions: 

• Heredity: Bunions themselves are not inherited but it is thought that a poor or faulty mechanical foot structure is inherited. 
• Ill-fitting shoes: Footwear is the main culprit for providing any pressure. Shoes that are too tight, too narrow, too small, high heeled or pointy toed can speed up the development of bunions. 
• Flatfeet: Flat or pronated feet are generally unstable and excessive pronation can increase the load on the foot – leading to bunions. 
• Other: Trauma can lead to bunions as well as deformities present at birth (congenital). People that spend a lot of time on their feet can also be prone to developing bunions. 

Signs & Symptoms 

Bunions can be either very painful or can exhibit no pain at all. The pain can also be persistent or intermittent and can range from mild to severe. 

• There may also be inflammation (redness) and /or swelling at or near the joint 
• The motion of the joint may be restricted, or repetitive motion may lead to pain 
• In more advanced cases the smaller toes can become bent or claw-like – a hammer toe 
• In some people corns and calluses can develop on the bunion, the big toe and the second toe due to the alterations in pressure from the footwear or by the overlapping toes. 

Treatment 

Treatment options vary depending on the severity of your bunion. Bunions will never reverse themselves and generally they worsen over time unless the cause is entirely eliminated. 

Conservative / Non-surgical treatments: 

• General Palliative Care: to remove any corns, calluses, or ingrown/problem nails. 
• Activity modifications: avoiding activity that causes pain, including standing for long periods of time and sports. 
• Footwear changes: As footwear plays such an important role in the development and symptoms of bunions, it is vital that the shoes fit correctly. Shoes should have a wide toe box and be reasonably flat to reduce any pressure.
• Padding: Different types of padding and toe spacers are available to prevent the big toe from angling outward and to relieve pressure against the bunion while wearing shoes. 
• Orthotics: Help control any excessive or abnormal motion of the foot and can help with any joint instability and slowing the progression of any bunion. Orthotics are also used after surgery to maintain the new stable and aligned foot position. Without this treatment the bunions may reoccur after surgical correction.