Bunions (Hallux Valgus)

A bunion is a painful lump that forms on the outside edge of the big toe due to pressure from your walking style or foot shape. Standing for long periods and wearing narrow shoes can aggravate bunion pain. If you don't get relief from bunion pads, toe spaces, and better-fitting footwear, surgery may be necessary (a bunionectomy).

What is a Bunion?

A bunion is an outward bump on the big toe. Years of pressure on the metatarsophalangeal (or MTP) joint in the big toe can cause this foot deformity. The toe joint eventually becomes out of alignment and a bumpy bony growth forms. Hallux abducto-valgus is the medical term for bunions.

Who Could Get Bunions?

Bunions affect up to one-third of Americans. Bunions are more common among older adults and women. Bunions may form on both feet or just one.

What types of bunions are there?

The most common type of bunion is on the big toe. Other types include:

• Congenital Hallux Valgus: Certain babies are born with bunions.
• Adolescent or juvenile hallux valgus. Teenagers and tweens between 10 and 15 years of age may develop bunions.
• Tailor’s bunion: This bunion is also called a bunionette. It forms at the base of the pinky toe.

SYMPTOMS & CAUSES

What Causes Bunions and What are They?

Your big toe may bend toward your second toe due to pressure from your walking style (foot mechanics) and the shape of your feet (foot structure). Bunions develop gradually. Bunions are not caused by standing for long periods of time or wearing narrow, ill-fitting shoes.

What are the risks factors for bunions?

If you:

• Bunions are inherited problems with the foot structure, such as flatfeet.
• Foot injuries.
• Inflammatory diseases such as arthritis rheumatoid.

What are the symptoms of bunions and how can you tell if they're present?

A bunions looks like a red turnip, which is swollen and red. Some sources claim that the word "bunion" comes from the Greek for turnip. Other symptoms include:

• The big toe is either unable to be bent or you feel pain and burning when trying to bend it.
• Difficulty in wearing normal shoes
• Calluses or corns (thickened, thickened skin)
• Hammertoes are painful, stiff toe joints and tendons.
• The big toe is numb.

DIAGNOSIS & TESTS

How are bunions diagnosed?

A bunion in Perth can be diagnosed by your healthcare provider just by looking at it. You can also have X-rays taken to check the alignment of your bones and any joint damage.

MANAGEMENT & TREATMENT

How do you treat or manage bunions?

Bunions do not disappear. Treatment usually focuses on relieving the symptoms and may include:

• Bunion pad and tape: Over-the-counter bunion pads cushion and relieve pain. Medical tape can be used to hold the foot in place.
• Changes in footwear: Changing to shoes with deep, wide-toe boxes will relieve pressure on your toes. It may be possible to widen your shoes using a stretch device.
• Orthotic devices Custom-made or over-the-counter shoe inserts can help control alignment issues, such as pronation which may contribute to the formation of bunions. A spacer can be placed between the second digit and big toe. Some people get relief from wearing a night splint to keep their big toe straight.
• Use ice packs in conjunction with nonsteroidal anti-inflammatory drugs to reduce swelling and pain.
• Physical Therapy: Massage and physical therapy, as well as ultrasound therapy, can help break up adhesions in soft tissues to reduce inflammation and pain. Exercises can be done to improve muscle strength and alignment around the bunions.
• Injections The use of steroid injections can reduce swelling and pain, but they may be harmful if injected too frequently or into the joint itself.
• Surgery When nonsurgical treatment does not help and walking is extremely painful, your provider may recommend surgical intervention. The procedure is known as a bunionectomy. Your provider will remove the bunion, realign the bones and bring the big toe into its correct position.

PREVENTION

How can I avoid a bunion?

The right footwear can help prevent bunions from forming or to keep an existing one from worsening. You can get advice from your healthcare provider on the best shoes to choose. Shoes with a soft sole and a wide toebox are best in general. Avoid shoes with a narrow toe box and high heels, which put pressure on your front foot. Custom-fitted orthotics may help to prevent or slow down the progression of bunions if you have flatfeet, or other structural foot problems.

OUTLOOK/PROGNOSIS

What are the consequences of bunions?

A bunion can increase your risk for:

• Bone Spurs.
• Bursitis
• Hammertoes.
• Osteoarthritis.

What is the outlook (prognosis) for those with bunions?

Bunions can become worse with time if you don't take the proper care. You may be sedentary if you experience severe pain while walking or standing. This is bad for your health and quality of life. Many people find relief from their symptoms with over-the-counter aids or treatments in a doctor's office. Surgery can be helpful if needed.

Living with

When should I consult a doctor?

If you have:

• Difficulty in walking.
• The big toe is stiff.
• Inflammation or severe redness of the toe joints.
• After surgery, you may experience symptoms of infection such as fever.

What should I ask my physician?

Ask your doctor:

• Why did I develop a bunion on my foot?
• What is the best treatment for bunions and how can you treat them?
• What can I to do reduce the chance of developing a bunions on my other foot.
• How can I reduce the risk of developing other foot problems such as calluses and corns.
• What can happen if I don't treat my bunions?

Note from Advanced Foot Surgery in Perth

Bunions are common. Although over-the-counter pain relievers and bunion pads can ease symptoms, it is best to consult a healthcare professional. Your healthcare provider may recommend alternative treatment options such as shoe gear modification, physical therapy and medications. Treatments are available to reduce the pain and prevent symptoms from worsening. Surgery to remove the bunions and realign your big toe may be necessary if the pain is severe.