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What Causes Bunions, and what can you do about them?

Bunions are basically abnormal lumps overlying the big toe joint AKA metatarsal joint. The medical name is ‘Hallux valgus’, and are common causes of pain in the big toe. 

Bunions can also be found on the 5th toe, called ‘Tailors Bunion’ as they were common among Tailors due to the way they were sitting while working.  

Bunions are a progressive disorder of the foot, and as such, they will typically lead to further problems of the little toes including clawed toes, subluxations and callous lesions. 🙃

 

Why do I have a bunion, what has caused this?

The truth is there are many causes of Bunions; however, research shows a high percentage of people are genetically predisposed to developing them. Others causes include;

  • Trauma to the feet
  • Poorly fitted shoes (pointy, high heels etc.) yip this does mean those fabulous shoes are slowly killing your feet. 🦶  I'm not saying you can never wear fancy shoes 👠 - but try to make wearing the high heels and the pointy toes a very rare occasion - or be prepared to suffer in pain. 
  • A natural degenerative change (arthritis) sorry 😐 to say this - but yip we are all getting older and this can just be your luck that this joint gets affected. 
  • Chronic irritation or pressure (sitting posture, work or sporting activities/demands) your body basically becomes what you do...
  • Poor biomechanics - how you walk, how you more. 

What are the symptoms I would expect to get with a bunion?

  • Visible boney lump overlying the joint (‘Bunion’)
  • Pain is localised to the bump area
  • Pain is reproduced through flexing the toe (bending it up and down)
  • Swelling, soreness and thickening of the skin overlying the area
  • Re-orientation of the toe (lateral movement) 
  • Often painful in heels or pointy shoes and during exercise

How is a bunion diagnosed? 🧐

The diagnosis is a combined of clinical assessment and x-ray. Clinical evaluation and a reduced range of motion of the joint in combination with pain upon palpation of the joint would make up the diagnosis. An x-ray will reveal an abnormal angle and arthritic changes.

What are the treatment options for bunions? 🥰

There are two types of treatment options, conservative and surgical and are based on the level of pain. Surgery would only be advised if it was painful and stopping you from performing daily tasks. 

 Conservative

The main goal is to reduce pain and to minimise or slow progression.

  • Resting and Icing inflamed joints. ❄️
  • Orthotics can be helpful depending on requirements - so a rigid orthotic would reduce the motion; thus there would be less pain.
  • Stretching exercises of the big toe 
  • Footwear: extra depth and width at the toe box will take away the pressure and slow down the progression of the bunion
  • Foam or silicone pads can be used to minimise pressure lesions
  • Toe Splints/manipulation

How can I prevent getting a bunion?

Many things can be done to delay the onset and progression of the disorder. Simple things you can do right away are to wear appropriate footwear, stretches and orthotic management.

References

Menz, H. (2008). Foot problems in older people. Assessment and Management. Churchill and Livingston, Chapter 8.

Footbionics: http://www.footphysics.co.uk/adult-pain-injury-conditions/foot-pain-causes-and-treatments/bunions-hallux-valgus/

 

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