Bunions, technically known as Hallux Abducto Valgus are the most common foot deformity that we come across in Podiatry. It is estimated that there is a prevalence of 23% to 35%. Bunions affect both men and women however they are more common in women (Possibly due to tight-fitting, narrow-toed and high heeled shoes).
What is a bunion?
A bunion is a deformity that occurs when the big toe bends/moves towards the other toes. This misalignment of the big toe joint (1st Metatarsophalangeal Joint) can often cause swelling, redness and pain in the area. Extra bone formation can also occur over time forming the “bump” at the base of the big toe that we call a bunion. It is usually a gradual and slow process. Any pain felt from bunions is often associated with Bursitis (The fluid filed sack adjacent to the joint becomes inflamed). A more deep joint pain can often be felt at the latter stages of bunion formation and this is usually caused by Arthritis that has developed inside the joint.
What causes bunions?
The precise cause of a bunion is not fully known but it is believed they are caused by multiple factors. These factors include:
Abnormal anatomy, function & mechanics such as overpronation (excessive flattening and inward motion of the arch and foot)
Genetic factors (hypermobility or ligamentous laxity is a condition where the ligaments and joints a very flexible and these conditions are thought to be inherited)
Leg Length Differences (Bunions often develop on the foot of the longer leg)
Certain medical conditions can increase the likelihood how developing bunions (Rheumatoid Arthritis, Gout, Polio, Multiple Sclerosis, Cerebral Palsy)
Bunions can be worsened by wearing the wrong footwear (Tight-fitting or Narrow-toed or high heeled shoes) or from carrying excessive weight or from prolonged standing.
Treatments for bunions
Bunions may only need to be treated if they are causing pain and discomfort and if the deformity is severe. Unfortunately there are not really any effective non-surgical options to reduce or reverse the development of a bunion however, non-surgical treatments can reduce pain and discomfort that one might feel from a bunion and most importantly, prevent it from worsening.
1.Modifying Footwear: Footwear should be adjusted to eliminate friction on the bunion. This will reduce the likelihood of developing Blisters, Corns and Bursitis on and around the bunion. Unsupportive and flimsy shoes can add stress to the structures around the big toe and therefore increase pain. A supportive shoe with a strong sole, laces and a wide and high toe box is recommended.
2.Toe Separators, Taping and Bunion Pads/Shields can be utilised: Bunion Pads/Shields are made from either silicone gel or fleece and these materials help to ease friction on the skin surrounding the bunion. Taping and toe separators can help to keep the toe in alignment and to prevent rubbing on the adjacent toes.
3.Orthotics/Insoles: An off the shelf or a custom made orthotic can help to keep the bones and structures within the foot in alignment and to address overpronation. Click this Link to learn more about orthotics
4.Stretching and Manipulation can also help: Gaining mobility, particularly at the ankle can control abnormal foot motion. A tight Achilles tendon can lead to overpronation of the foot so consistent daily stretching of the tendon can alleviate this causative factor.
Foot Mobilization Therapy can help to preserve the joints mobility and slow down the progression of arthritis within the joint.
5. Reduction of swelling and inflammation: Painkillers and anti-inflammatories such as paracetamol or ibuprofen can help with pain and swelling in the short term. A cold compress or cold pack a few times daily can help with swelling and inflammation also.
Note: If the right shoe and conservative treatments don’t help and the pain is severe, then surgery might be necessary. You should discuss this option with your Podiatrist if you feel it is something that is necessary.
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