Got Bunions?

As a podiatrist the number one question people ask me is, what is a bunion?  And the second most common question is what causes it?

What is a bunion?


When your big toe is angled towards the second toe, the deformity is called a bunion (hallux valgus). This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful.

Sometimes a fluid-filled sac (bursa) develops over the joint.


What causes bunions?

The underlying cause is a deformity of the joint at the base of the big toe. The deformity is called hallux valgus. In this deformity the joint develops a prominent sideways angle. Due to this deformity the bones of the big toe are pushed towards the smaller toes.

The skin over the angled joint then tends to rub on the inside of shoes. This may cause thickening and inflammation of the overlying skin and tissues next to the affected joint.

In most cases it is not clear why a hallux valgus deformity develops. There may be some hereditary (genetic) tendency to have a weakness of this joint. In some cases it is associated with a joint problem such as osteoarthritis or rheumatoid arthritis.However, whatever the underlying cause, wearing tight or badly fitting shoes tends to make the problem worse. Wearing such shoes puts extra pressure on the big toe joint and causes friction on the overlying skin.

What symptoms and problems are caused by bunions?

  • Pain. You may then have difficulty walking due to pain.
  • Inflammation and swelling at the base of the toe. This sometimes becomes infected.
  • The foot may become so wide that it can be difficult to find wide enough shoes.
  • You may get arthritis in the big toe.
  • The second toe can become deformed.
  • In severe cases, the big toe can push your second toe up out of place.


What is the treatment for bunions?

  1. Choosing the right footwear, look for shoes that fit well, but are still roomy.The shoe’s heel should not be to high,  pointed or too tight in the front. Shoes with laces or straps are better, as they can be adjusted to the width of your foot.
  2. Exercises-  Working on the intrinsic muscles of the
    foot.  One of the exercises that have my patients do, is to put their
    foot on a towel and try to “roll” up the towel with their foot. There
    are two benefits to this exercise.  One is that it strengthens the foot
    and  it works the big toe joint into flexion range of motion adding over the bunion may help, as well as ice packs.

  3. Orthotics, ie. inserts, which help to realign the bone.
  4. Medication- Painkillers such as paracetamol or ibuprofen may ease any pain. If the bunion (hallux valgus) develops as part of an arthritis then other medication may be advised.
  5. And if all else fails, the last option would be surgery. The aim of the operation is to straighten the joint as much as possible and relieve pain. It is not usually done just to improve appearance.
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