A bunion is generally considered as an enlargement of the joint at the base and side of the big toe. Bunions form when the big toe bends towards the others causing the joint to become larger. The bunion can become painful, and in many cases arthritis and stiffness can eventually develop. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint – most of the time the two go together and can just be referred to as ‘bunions’.
What are the symptoms of bunions?
Bunions start as the big toe begins to turn and develop a firm bump on the inside edge of the foot, at the base of the big toe. Initially, the bunion may not be painful but as the toe deviates more there may be pain near the joint with redness and swelling. The pain is most commonly due to two things – it can be from the pressure of the footwear on the bunion or it can be due to arthritis like pain from the pressure inside the joint. The motion of the joint may be restricted or painful.
A hammer toe of the second toe is common with bunions. Corns and calluses can develop on the bunion, the big toe and the second toe due to the alterations in pressure from the footwear. The pressure from the great toe on the other toes can also cause corns to develop on the outside of the little toe or between the toes. The change in pressure on the toe may predispose to an ingrown nail.
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What causes a bunion?
The most common cause of Hallux valgus and bunions is instability in the front part of the foot. There is a large hereditary connection with foot type explaining why bunions are passed down through the family. Tight fitting footwear will aggravate a bunion and accentuate the problem but are not the only cause.
Bunions are mostly a result of an imbalance in the forces that is exerted across the joint during walking, which leads to instability in the joint. Bunions can also follow foot injuries and develop in those with neuromuscular problems. Those with flat feet or pronated feet appear to be more prone to the instability in the joint and have a higher incidence of bunions. Such faulty foot mechanics can be assessed and treated by a podiatrist or one of our Chartered Physiotherapists
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Treatment
Treatment is simple:
1. address any footwear issues that are present
2. correct the imbalance within the foot using an orthotic device
3. if the problem persists then a surgical referral is necessary
The initial goal of treatment is to relieve pressure on the bunion and to halt or slow the progression of the joint deformity. Although surgery is the only way to fully correct bunions, there are a number of things that our Podiatrists and Chartered Physiotherapists can do to help the symptoms and improve range of motion.
Custom orthotics may be useful in helping with the instability about the joint. Our Chartered Physiotherapists can assess your feet using a Gait scan to determine where the instability lies. Orthotics will play a role in slowing progression and in the prevention of bunions developing again post-surgery. Our physio’s will also provide advice on correct fitting footwear, with a personalised fitting services of your custom orthotics.
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