Technically known as hallux valgus, a bunion is a bony deformity of the joint at the base of the big toe. Often red in appearance, a bunion can be, and often is, painful.

What causes bunions?
The short answer is: nobody knows. Some think that high heels or tight fitting shoes can cause them, but they are also found in societies where shoes aren’t worn. Others think that genetics could play a factor, as the condition can run in families. But, as there’s no known ‘gene for bunions’ – it is more likely that it’s abnormal skeletal biomechanics that are inherited – which can lead to bunions. Of course, tight fitting shoes won’t help the situation – they are very likely to make the condition worse.

If bunions have a genetic cause, you’ll either be predisposed to them or you won’t. You can’t (yet!) change your genetic make-up on demand. However, if you suspect that you might be prone to them, there are things you can do to ‘discourage’ them – mainly to do with footwear. The single biggest thing you can do is to ensure that you wear shoes with a broad toe box (area at the front of the shoe), and wear high heels sparingly if at all.

Treatment – non-surgical
If you’re unlucky enough to develop a bunion, you’ll need to treat it. Treatments fall into two main categories: surgical and non surgical. You should always try the non-surgical options first. These are:

  • Change your footwear. Choose shoes that have a wide toe box, and which are flat or low-heeled. High heels, and shoes with pointed toes, should be avoided.
  • Avoid certain activities. Activities such as long periods of standing can make the condition worse.
  • Orthotics. These are special shoe inserts that decrease the pressure on the bunion. They can be purchased OTC (over the counter) or be custom made. Your GP will advise you as to the most suitable solution for you.
  • Ice packs. The application of an ice pack can help reduce inflammation and pain. You may need to do this several times a day.
  • Padding. Pads over a bunion will help to prevent rubbing against shoe surfaces.
  • Medication. Anti-inflammatory drugs such as ibuprofen, and pain-killers such as paracetamol may help.

It’s important to note that, although non-surgical treatments provide pain relief, they won’t improve the appearance of your foot.

Treatment – surgical
In some cases, surgery may be required. This can include anything from removing parts of bone and fusing joints, to creating completely new joints.