Overview of Bunions
A bunion, also known as hallux valgus, is a bony bump that forms at the base of the big toe, where it joins the foot. This condition occurs when the big toe deviates toward the second toe, causing the joint at the base of the big toe to stick out.
Bunions are caused by a combination of genetic and environmental factors. A common contributing factor is footwear, particularly shoes that are too tight, narrow, or have high heels, as they can exacerbate or accelerate the development of bunions. However, genetics play a key role; if your family has a history of bunions, you may be more likely to develop them. Other factors include flat feet, arthritis, or certain foot deformities.
Bunions appear as a noticeable bump on the inside of the foot, near the joint at the base of the big toe. Over time, the bump can grow larger, and the toe may angle inward, pushing the second toe out of alignment.
Common symptoms of bunions include:
Pain or tenderness at the bump, especially when wearing shoes.
Redness and swelling around the bunion area.
Restricted movement of the big toe.
Difficulty walking or discomfort while standing for long periods.
In more severe cases, the second toe may overlap the big toe.
Bunions are more common in women, largely due to wearing tight, narrow shoes or high heels that can exacerbate the deformity. However, anyone can develop bunions, particularly individuals with flat feet, overpronation (when the foot rolls inward), or a family history of bunions. Athletes who put excess pressure on the feet, such as dancers or runners, are also at risk.
As long as bunions do not cause any pain, there is no increasing deformity or the second toe is not affected bunions do not need to be corrected surgically.
Treatment for bunions depends on the severity of the deformity and the level of discomfort it causes.
In milder cases, conservative management can be very effective. This includes wearing wide, comfortable footwear with a spacious toe box to reduce pressure on the bunion, using orthotic insoles to improve foot alignment, and applying padding or gel sleeves to reduce friction. Anti-inflammatory medications or ice packs can help manage pain and swelling. Stretching and strengthening exercises for the foot may also help slow the progression.
However, when conservative measures fail to relieve symptoms, or if the bunion causes significant pain, limits mobility, or leads to secondary problems like overlapping toes or joint stiffness, surgical intervention may be necessary.
Bunion surgery, known as a bunionectomy, involves removing the bony prominence and realigning the bones, ligaments, and tendons of the foot. There are various surgical techniques, including osteotomy (cutting and repositioning the bone), soft tissue realignment, or fusion procedures in more advanced or arthritic cases. Recovery can vary depending on the procedure, but typically includes a period of immobilisation in a stiff-soled post-op shoe for up to 6 weeks, limited weight-bearing using crutches, and a gradual physiotherapy programme.
Most patients can expect to return to normal footwear in 6 - 12 weeks, though full recovery and swelling resolution may take several months.
