A bunion (technically known as hallux valgus) is a bony deformity, or swelling, of the joint at the base of the big toe. The main sign of a bunion is that the big toe points towards the second toe on the same foot, which usually forces the foot bone attached to it to stick outwards. 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, as bunions can run in families, genetics could play a factor. But, even if this is the case, there is no ‘gene for bunions’ – it is more likely that abnormal skeletal biomechanics are inherited, which then lead to the formation of 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 – to slow their formation. These are to do with footwear – make sure you wear shoes with a broad toe box (area at the front of the shoe) to comfortably accommodate the toes, 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. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box, and which are flat or low heeled. If you wear leather make sure that the material is soft. High heels, and shoes with pointed toes, should be avoided.
- Avoid certain activities. Try to avoid activities, such as prolonged standing, that exacerbate the condition.
- Orthotics. These are special shoe inserts that reduce bunion pain by decreasing the pressure on it. Orthotics can be bought over the counter or be custom made. Your GP will advise you as to the most suitable solution for you.
- Icing. The application of an ice pack several times a day can help reduce inflammation and pain.
- Padding. Pads placed over a bunion will help to prevent it from rubbing against the shoe, thus minimising the pressure on it.
- Medication. Anti-inflammatory drugs such as ibuprofen, and pain killers such as paracetamol may help to reduce pain and inflammation.
Note that, although non-surgical treatments provide symptomatic relief (pain relief), they won’t improve the appearance of your foot.
Treatment – surgical
In some cases, surgery may be indicated. This can include anything from removing portions of bone and fusing joints, to creating completely new joints.