A bunion is the result of a deformity of the big toe. The long bone in the middle of the foot (metatarsal) becomes deviated towards the other foot, whilst the big toe (Hallux) pushes to towards the smaller toes. As a result the joint becomes prominent on the inside of the foot. This prominence is termed the bunion and it can often become inflamed if it rubs on shoes.
In severe cases a bursa (rather like a deep blister) is formed and this can become inflamed (bursitis). The abnormal position of the joint can cause wear and tear, resulting in arthritis within the joint. The medical term for this deformity is Hallux Valgus because the big toe assumes a valgus position.
What causes bunions?
There are many possible causes and they can be associated with diseases of the joints such as osteoarthritic and rheumatoid arthritis. However, poorly fitting shoes with narrow toe boxes can precipitate the problem although this is not the only contributing factor. Abnormal foot function can predispose to the deformity as bunions are found in races that do not wear shoes. In many cases, it can be an inherited problem with the condition present in more than one generation of the family.
Are women more likely to get the problem?
It is more common in women as they tend to wear tighter, narrower shoes with increased heel height. These shoes place a lot of pressure onto the joint and predispose to deformity.
Will it get worse?
Most of the evidence indicates that the deformity is progressive and deteriorates with age. For this reason, it is more common with increasing age.
Conservative Measures: Initially, podiatrists often recommend non-surgical or conservative approaches to manage bunions. This can include wearing properly fitting shoes with adequate arch support and cushioning, using orthotic devices or shoe inserts to redistribute pressure, and doing exercises to improve joint function and alleviate pain.
Custom Orthotics: Podiatrists can create custom orthotic devices designed to provide support, correct imbalances in foot structure, and relieve pressure on the bunion.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to manage pain and inflammation associated with bunions.
Padding and Taping: Podiatrists can apply padding or tape to help alleviate pressure on the bunion and reduce friction between the bunion and the inside of your shoe.
Footwear Recommendations: Podiatrists can provide guidance on choosing appropriate footwear that accommodates the bunion and minimises discomfort.
Physical Therapy: In some cases, physical therapy may be recommended to strengthen and stretch the muscles and tendons around the bunion joint.
Surgical Intervention: If conservative treatments do not provide pain relief your podiatrist may recommend surgical correction. Bunion surgery involves realigning the bones and soft tissues of the affected joints to alleviate pain and improve function.
If you suspect you have a bunion or are experiencing foot pain related to a bunion, it is a good idea to consult with a podiatrist. They can assess the severity of your condition, discuss your treatment options, and help you make informed decisions about the most appropriate course of action based on your individual circumstances. Early intervention and management can help slow down the progression of bunions and reduce associated discomfort.