If you have a hard, bony bump on the outside of your big toe, you likely have a bunion. A bunion—also known as hallux valgus—develops when your bones shift out of place, creating a noticeable protrusion when your big toe is pulled in the direction of your smaller toes.

They are not only a cosmetic concern for people, they can also cause a great deal of pain and discomfort.

Bunions can form on one or both feet. Unfortunately, they grow bigger over time. The bigger the bunion, the more uncomfortable it may be to wear shoes and the more impact it will have on your activity level and quality of life.

What Are Bunions, and Who Gets Them?

Bunions are a progressive condition, meaning that without intervention it will get worse and more painful over time.

The bony deformity is caused when the big toe bone (metatarsal) gets pushed inwards towards the second toe, while the base of the big toe deviates outward. This shift causes a bony prominence on the inside of the foot (the ‘bunion’). Contrary to popular belief, it is not a new or extra bone growth.

As the position of the big toe shifts further, it often also causes overlapping the other toes, which can cause further pain and discomfort.

While adolescents can sometimes develop bunions, these foot deformities are more common among adults. They are particularly prevalent among older women, including women who wear shoes that crowd their toes (high heels or pointed-toe shoes, for example). Women are also more susceptible to developing bunions on account of their foot anatomy; they have lower arches, narrower feet, and a more flexible foot structure.

What Causes Them?

There are a number of causes and risk factors to developing bunions, including:

• Age – As we age, this conditions becomes more common.
• Gender – more prevalent in women
• Genetics and family history
• Foot wear (high heels, narrow toe box)
• Inflammatory joint disorders (e.g. rheumatoid arthritis).
• Foot conditions such as flat feet and lax ligaments.

While most bunions take years to develop, it’s important to be aware of their presence and take note of any pain or other unpleasant symptoms that they cause you to experience so you can decide if bunion surgery is right for you.

What Are the Symptoms of Bunions?

Your big toe joint is responsible for bearing a significant portion of your body weight when you are standing and walking or running. Most commonly pain is experienced around the bunion when wearing shoes, which increases when doing any weightbearing activity.

Common symptoms include:

• Pain
• Swelling
• Redness
• Joint stiffness in the big toe – this is a less common symptom

Pain may also be experienced under the balls of the toes (metatarsalgia) joint, and you may also experience secondary foot issues, including the formation of hammertoes, corns, and calluses.

A bunion can alter the biomechanics of your forefoot and affect the way that you walk or run. This can cause issues with other parts of your body such as your knees, hips and back.

Bunion surgery may be the only way to remove a bunion and completely correct the problem.

What is Bunion Surgery and When is it Indicated?

Though bunions aren’t considered a serious medical condition, as they grow that can become very troublesome, painful and unsightly.

Bunion surgery is indicated when conservative treatments such as custom orthotics, bunion shields, and anti-inflammatory medications have not been effective in alleviating your pain and the discomfort associated with the bunion. 

Surgical intervention should be considered if:

• Your ongoing big toe pain continues to worsen
• If your walking or running is being affected
• If the bulging bump on the outside of your toe continues to grow bigger
• If you have stiffness and decreased movement in your big toe or your foot
• If you are becoming increasingly frustrated with how difficult it is to find footwear that fits well
• If your activity level is decreasing and you are low in mood due to your condition.

It is important not to delay surgery for too long, as ignoring your symptoms will just lead to secondary complications, poor mobility and reduced quality of life. It also often means that a more invasive procedure will be required to correct the deformity.

Some patients with bunions have no symptoms at all, in which case there is no indication for surgery. Surgery should not be performed for cosmetic reasons alone.

What Does Bunion Surgery Involve?   

The surgery that is required will depend on the severity of your condition. In most cases it is performed as a minimally invasive procedure which only a very small excision.

For mild cases, the surgery required is quite minimal. However, in general more severe deformities will require your bunion surgeon to perform a procedure to break the bone, realign it and reset it with 2 or 3 small screws to fix it into the desired position.

Sometimes severe deformities or patients with arthritis may require a fusion of the big toe joint. This provides excellent pain relief and stability of the joint.

Bunion Surgery is performed as a Day Case procedure, under a local anaesthetic ankle block. You can be awake, sedated or have a general anaesthetic during surgery, which takes about 45 minutes.

Most patients do not experience significant pain after surgery, although you will need to take some pain relief for a couple of weeks following your operation.

Post op you will be required to wear a stiff-soled shoe for up to six weeks post-surgery, and you will likely need to have some Physiotherapy rehabilitation to help you regain your strength and mobility.

How Does Bunion Surgery Provide Relief from Pain? 

Bunion surgery provides relief from pain by realigning the bones in your big toe joint. Once those bones are returned to their proper position and the bunion is removed, you should no longer experience pain or discomfort, and you can go back to all your normal activities.

Bunion surgery also works well to reduce sore and inflamed tissues that surround your big toe. Since inflammation is closely related to pain, a reduction in inflammation will also help to provide reduced pain

Following successful bunion surgery, your foot will function as normal, your movement and stiffness will improve, and you will be able to mobilise pain free.

When your foot posture and movement is back to functioning normally, you will put less strain/pressure on the big toe joint, and your lower limb biomechanics will improve. This leads to better movement and function of your other joints and will improve/prevent you from developing pain in other parts of your body.

Bunion surgery is considered a safe and effective procedure for alleviating pain and improving your overall foot function.

If you have any questions about bunions, your bunion surgery or your post op recovery, please get in touch with Mr Klinke - we are here to help you on every step of your journey and ensure that you have a smooth and stress free recovery.

Have you recently found out you need bunion surgery in London? Do you suspect you have bunions but don’t know what to do about them?

Approximately 14 million people in the UK deal with bunions.

If you’re one of them (or think you might be), this guide is for you. It breaks down everything you need to know about diagnosing and treating bunions.

What Are Bunions?

Bunions are bony bumps on the joint that connects the base of the big toe to the foot. Some people also develop “bunionettes” — more minor bumps on the joint at the bottom of the little toe.

What Are Bunions Made of?

Bunions occur when bones in the foot shift out of place. When the bones move, the tip of the big toe gets pulled in toward the other toes. As a result, the joint below the big toe sticks out.

Symptoms of Bunions

A bump on the side of the foot is the most common symptom of bunions. However, you might experience other symptoms, including these:

• Pain and stiffness in/around the big toe joint
• Swelling of the big toe joint
• Difficulty walking 

You might also develop corns or calluses between the first and second toes due to them rubbing together.

What Causes Bunions?

Several issues can contribute to bunion development. The following are some of the most well-known causes:

• Genetics: If your family has a history of bunions, you’re more likely to develop them as well
• Medical conditions: Conditions like gout, osteoarthritis, and rheumatoid arthritis can increase your risk of experiencing bunions
• Poorly fitting shoes: If you frequently wear shoes that compress your toes (such as high heels with pointy toes), you’re more likely to deal with bunions
• Foot type: Those with low arches or flat feet are more prone to bunions

Foot injuries or birth deformities can also increase your risk of developing bunions.

How to Treat Bunions

Not everyone with bunions needs surgery — at least not right away. Here are some treatment options you can consider if you’re experiencing bunions:

Bunion Pads

Bunion pads are small cushions that create a soft barrier between your foot and your shoe. Adding extra cushioning can provide some relief and reduce pain while standing or walking.

Shoe Inserts

You can also purchase shoe inserts for additional comfort while standing or walking. Shoe inserts allow for more even pressure distribution when you move, which helps to prevent bunions from getting worse.

You may find over-the-counter inserts that work for your symptoms, or you may need to talk to a specialist about prescription inserts.

Changing Shoes

Whether you choose bunion pads or shoe inserts, you’ll likely find that certain types of shoes are no longer ideal for you.

If you frequently wear narrow shoes or shoes that compress the toes, it’s time to invest in some more comfortable and supportive alternatives. Otherwise, you’ll end up worsening your bunion symptoms.

Ice

Applying ice to your bunions — especially after standing or walking for extended periods — can reduce inflammation, swelling, and soreness. However, those with circulation issues or reduced feeling in their feet should consult a physician before trying this technique.

Medication

Many people find relief from the pain, inflammation, and soreness associated with bunions by taking over-the-counter medications like paracetamol or ibuprofen.

Injections

If over-the-counter painkillers alone aren’t sufficient for reducing bunion pain, you may also want to consider steroid injections. These injections reduce swelling and are particularly helpful for those who also struggle with osteoarthritis or rheumatoid arthritis.

Surgery

Surgery may be your best option for long-term bunion relief, particularly if the above treatments don't work.

Bunion surgery involves the following:

• Cutting bones to realign them in the correct position and fix them with small screws
• Removing prominent bone that causes pain
• Releasing some soft tissue and tightening other parts of the joint
• Cutting out swollen tissue from around the big toe joint

Most physicians recommend bunion surgery to those who experience pain caused by the bony prominence of the bunion.

Surgery might also be helpful when the pain is getting worse or you can’t find properly fitting shoes. Surgery is necessary when your second toe is starting to hurt or changes alignment eg starts to look like a hammer toe.

Schedule Bunion Surgery in London Today

If you suspect you’re dealing with bunions, meet with a foot specialist as soon as possible. They can diagnose your condition and help you develop a comprehensive treatment plan.

Dr Klinke is one of the leading foot specialists in London. If you’re considering bunion surgery in London or just want to know your options, book an appointment today.

Martin Klinke is a world-renowned foot specialist who has been practising in London for over 20 years. He has dedicated his career to helping people with foot problems and has helped patients regain mobility and quality of life. Mr Klinke is one of the leading foot specialists in London with qualifications in orthopaedics and sports medicine.

He can help you with everything from bunions to Achilles tendinopathies and much more. He's a consultant at the London Foot and Ankle Centre and London Bridge Orthopaedics, and he offers a wide range of services designed to meet your needs. So, if you're looking for a "foot specialist near me," be sure to give Martin Klinke a call.

Martin Klinke Excellence in Foot and Ankle Care

Total Ankle Replacement Focus

Martin Klinke is one of only a handful of surgeons in the United Kingdom with a focus on total ankle replacement. This means he can provide you with this cutting-edge procedure if you have end-stage arthritis or other conditions that haven't responded to conservative treatment. Total ankle replacement can relieve pain, improve function, and restore quality of life for many patients.

If you're looking for an ankle replacement surgeon in London, look no further than Martin Klinke. He has the experience and expertise to get you back on your feet and enjoying life again.

Biologic Foot and Ankle Treatment

Martin Klinke is also a pioneer in the use of biologic treatments for foot and ankle conditions. Biologics are substances derived from living organisms and can be used to promote healing and reduce inflammation.

Some of the biologic treatments that Mr Klinke offers include platelet-rich plasma injections which may help to stimulate your healing process. These cutting-edge treatments can help you heal faster and get back to your normal activities sooner.

Managing Surgical Pain with Less Medication

Martin Klinke is committed to helping his patients manage their pain with less medication. He offers a variety of options for postoperative pain management, including local anaesthesia, nerve blocks and various physical therapies. These techniques can help you stay comfortable during your recovery and get back to your normal activities sooner. The thing is, when you're in pain, it's tough to stay positive and motivated.

That's why Martin Klinke also offers psychological support to his patients. He understands the importance of a positive outlook during recovery and will work with you to ensure that you have the support you need to heal properly.

Moving Foot and Ankle Care Forward

Martin Klinke is always looking for ways to improve the care he provides to his patients. He is constantly researching new treatments and procedures and is always up-to-date on the latest advances in foot and ankle care. This means that you can be confident you're getting the best possible care when you see Mr Klinke. He is committed to providing his patients with the best possible outcomes and the highest quality of life.

The Comprehensive Services He Offers

Martin Klinke treats a wide spectrum of foot-related conditions and is passionate about helping his patients achieve their goals and live their best lives. He will work with you to develop a treatment plan tailored to your specific needs. Whether you're looking for relief from pain or you want to improve your function, he can help.

Why Choose Martin Klinke, Foot Specialist London?

There are many reasons to choose Martin Klinke as your foot and ankle specialist. Here are just a few:

• He is a leading expert in his field
• He has a wealth of experience
• He offers comprehensive services
• He uses cutting-edge treatments
• He is committed to helping his patients achieve their goals
• He has a passion for his work
• He is dedicated to his patients

Why You Should Seek the Services of Martin Klinke for Your Foot and Ankle Needs

These and many more reasons are why you should entrust your foot and ankle care to Martin Klinke. He is dedicated to providing you with the best possible care and treatment and will work tirelessly to help you achieve your goals. Contact Martin Kinke's office today to learn more about what he can do for you.

While a great deal of us have heard of the condition known as Plantar Fasciitis, far fewer may know exactly what it is, how it affects us and how exactly it is treated. Despite its rather exotic name, it is quite a common condition, one which can cause a great deal of pain on the underside of the foot, typically under the heel but also along the arch of the foot causing tenderness to the touch. It is a condition that can be particularly bad after periods of non-weight bearing, for example getting up in the morning or after long periods seated. It can also cause pain after long periods on your feet, yet you might be fine while you are active. Typically the pain subsides at some stage, and the condition itself can also be temporary, lasting anywhere up to around a fortnight. For some, however, it can be a longer term problem requiring professional advice and medical intervention.

Causes

Plantar Fasciitis develops when the tissues running between the heel area up to the foot’s arch become inflamed. This area acts as the body’s natural shock absorber but can easily become damaged from repetitive daily wear and tear, sudden impacts or just something as simple as a barefoot walk across hard ground. There are links between the onset of Plantar Fasciitis and a sudden increase in activity levels, placing those who might have started jogging, joined the gym or taken up other physical activities at more risk. There are also strong links between the condition and obesity as well as those with flat feet.

Diagnosis

Generally, if the condition hasn’t improved within a fortnight, it may be a longer term issue and making an appointment with your local GP should be considered. Typically your doctor will explore the history of your condition and undertake a physical examination to rule out other potential causes of the pain. This may involve touching the heel to see if it causes pain and asking you to flex your toes upwards to tighten that area between heel and arch (the fascia) to examine it under tension.

Ultrasound might also be an option to help ascertain the fascia’s thickness. A thickness greater than 4mm is generally indicative of the condition and a diagnosis can be made.

Easing the pain

There are several things you can undertake yourself to help alleviate the pain caused by Plantar Fasciitis. The most common (and one of the most effective) is comfortable, supportive footwear with particular focus on the heel and the arch of your foot, making trainers and sports shoes ideal. The comfortable shoes should raise your heel a little bit and support your arch. Stretching your calf muscles three times a day for a few minutes is also very effective. Rolling your foot over a small soft ball such as a golf or tennis ball is also effective for stimulating and helping to stretch your foot. Some people also find pain relief from the application of ice packs or packs of frozen peas wrapped in a towel every few hours. For those still looking to keep fit and active, swimming or cycling is an ideal form of non-weight bearing exercise.

Important things to try and avoid are long periods on your feet, walking barefoot (particularly on hard surfaces) and any footwear that is backless such as flip-flops or sandals. Whether Plantar Fasciitis is a condition you’re able to successfully manage and treat at home or whether you need the advice and support of an orthopaedic foot and ankle specialist, effective treatment is nearly always a combination of understanding and managing the mechanics of your foot and treating the problem area. In persistent painful cases a steroid injection or extra-corporeal shockwave treatment might be needed to help combat inflammation. Extra-corporeal shockwave treatment is a well recognised, successful and safe treatment option which stimulates the soft tissue to heal within a short period of time. 

Sufferers generally make a full recovery but it is important to remember that often there is a specific reason why people develop Plantar Fasciitis in the first place. This is the key reason why seeking the help of a medical professional is a good idea, to help ascertain the root cause of the problem and prevent it from recurring further down the road.

Lesser toe deformities are a common problem and often associated with big toe deformities. The lesser toes are linked to the foot by multiple soft tissue structures, the strongest one is on the sole of the foot and is called the plantar plate.

With forefoot overload, this structure can rupture and until recently this problem was very difficult to treat. Detecting this pathology with the help of thorough clinical examination and an MRI scan can lead to a successful repair of this important stabiliser of the toe joints. Special techniques and dedicated instruments now allow to repair the plantar plate. This means that the plantar plate is re-attached to the toe, therefore, the function of the toe is preserved.

This makes extensive and “debilitating” forefoot surgery unnecessary.

Are you suffering from pain or problems with your feet, contact me today.

Pain in the big toe joint can be caused by inappropriate footwear, big toe deformity, inflammation in the joint or some wear and tear in the joint. Once cartilage is damaged it does not grow back. This can lead to arthritis in the big toe joint called hallux rigidus. When conservative treatment has failed, surgery becomes an option. In milder forms of degeneration, one can perform a cheilectomy which removes prominent bone and any inflammation in the joint. In the more severe cases, a fusion of the big toe joint becomes necessary. This means the joint is made stiff and does not move.

For a few years now a new implant has become available that provides another successful treatment option. The so-called Cartiva implant “resurfaces” part of the joint, it helps to reduce the pain further and preserves the range of motion. This implant is a synthetic substance similar to the one used in contact lenses. Implanting the device does not need a lot of bone resection but is rather a “resurfacing” of the joint. So far, short and midterm results have been very good, reducing the need for a fusion substantially. The Cartiva implant is associated with very high patient satisfaction rate.

If you are suffering from pain in the big toe joint, contact me today.