Oh bunion… There art thou!

Bunion_Progression_Scale

A bunion, or hallux valgus, appears as a bump which develops at the base of the big toe. It forms when your big toe, or hallux, pushes against the second toe. This forces the big toe joint to stick out and get bigger.

You may notice that with time the skin over the bunion may get red and sore, and may develop callus or corns. This is from the pressure and friction that your shoe exerts on the area.

Hence, wearing narrow and tight shoes may cause a bunion or make it worse. However, bunions may also develop if we inherit a structural defect from our parents. For instance, if your mother has a bunion, you may be more susceptible to develop one too. They may form due to stress on the foot or due to a medical condition, such as arthritis.  

It is possible to develop a smaller bunion, also known as a tailor’s bunion or bunionette, at the base of your little toe. Like with the bunion on the big toe, bunionettes may be caused by ill fitting footwear, genetics or medical conditions.    

"...bunions tend to be very rare in populations that do not wear shoes..."

Symptoms

The most obvious sign of a bunion is a bulging bump on the outside of your big toe. It may be red, tender or swollen and you may develop corns or calluses on top of the lump or where the first and second toes overlap. If arthritis affects the toe, the range of motion becomes restricted making it more difficult to move your toe. Either intermittent or persistent pain may accompany the condition.  

bunion_symptoms

 

Causes

The exact cause of bunions remains unknown, however factors contributing to their development include:

  • Genetics – if other family members have bunions, you may be at an elevated risk.
  • Arthritis – particularly the inflammatory type, known as Rheumatoid Arthritis but also Gout or Psoriatic Arthritis may be linked to bunion formation.
  • Medical Conditions – which cause your ligaments to become more loose, your joints to become more flexible or your muscle tone to decrease, all may increase the likelihood of developing bunions.
  • Poorly fitting shoes – it is suggested that shoes which are too narrow, tight or on a high heel may contribute to the development of bunions. Interestingly, bunions tend to be very rare in populations that do not wear shoes.
  • Abnormal foot alignment – for example in people with flat feet.

Treatment

If the bunion causes you discomfort and pain, you may choose to start a treatment. First line of treatment is non-surgical, however you may choose to have a surgery if the deformity is severe and causes significant discomfort.

Non-Surgical Treatment Options

Our Podiatrist at South Dublin Podiatry will discuss the treatment options which are best suited to your condition.

There is a wide variety of non-surgical treatments which may ease the pain and discomfort, however, it should be noted that these will not correct the deformity or stop it’s progression.

These include:

  • Painkillers – such as paracetamol or ibuprofen. Always consult your doctor or pharmacist before taking any new medication and read the label carefully.
  • Bunion Guards – reusable bunion pads made of gel or fleece may be purchased over the counter in pharmacies. They protect the skin over the enlarged joint of your big toe from rubbing on the shoe and help to relieve pressure.  
  • Toe spacers – can also help to reduce the pain caused by bunions. They may be bought over the counter in pharmacies or can be custom made to your toes by our Podiatrist on the day of your appointment.
  • Ice Packs – or cold compress may help to reduce any swelling and numb the pain.
  • Orthotics – also known as insoles, are devices inserted into your shoes which help to realign bones of your feet and take pressure off your bunion.
  • Exercises – which strengthen the intrinsic forefoot muscles may also be beneficial. Our Podiatrist at South Dublin Podiatry will advise you on the most appropriate exercises depending on the severity of your bunion.

Surgical Treatment

A surgery is the only treatment which corrects the bunion and may be advised if above methods fail in alleviating symptoms or if your bunion is severe and you suffer from significant pain which affects your quality of life.

Bunion surgeries are not carried out for cosmetic reasons alone. They aim to improve your bone alignment and to relieve the pain. However, it is important to note that as with all surgeries, there will be a risk of wound infection which may lead to prolonged healing. Other risks include your toe joint becoming less flexible and the toe becoming shorter. You may also experience stiffness in the joint which was affected. According to HSE bunion surgeries may be up to 85% successful, however after the surgery there is no guarantee that your foot will be perfectly straight and pain free.

If your big toe joints are sore or you suspect you have a bunion ask our Podiatrist for an assessment and a solution to your pain today.

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