BUNIONS: What Are Bunions and How Can A Podiatrist Help?

What Are Bunions?

Bunions are a very common condition that we often see in the clinic, usually because the patient gets pain in the bunion or they believe their toe is unsightly.

A bunion is often described as the bony bump on the side of the big toe. The visual bump reflects changes in the bony structure of the forefoot. The medical term for a bunion is ‘Hallux Abducto Valgus’ (HAV). The term refers to the positioning of the toe, as it starts to turn inwards and overtime starts to move towards the lesser toes, creating a wider forefoot.

Why Bunions Develop?

A bunion forms when there is increased pressure and force placed on the big toe joint. Some common causes include:

• Hereditary factors (by far the biggest factor)
• Prolonged use of shoes that are too narrow
• Biomechanical factors 
• Arthritis in the feet 

The most common contributing factor is genetics. If you have noticed a bunion on your parent’s feet or even grandparents’ feet, chances are you have a higher chance of getting it!  Although the leading contributor, it is often a combination of all other factors as well.

The second biggest factor is footwear. If you imagine your foot in a tight-fitting shoe, causing it to be squashed and in an awkward position where the toes are crammed together and the big toe joint naturally sticks out, overtime this will cause a more permanent change within the joint, causing the big toe to move towards the 2nd toe and your other toes to claw. 

Signs, symptoms & progression of bunions

Although bunions are not always symptomatic, they are a progressive disorder, which means they worsen over time. They begin by a slight lean of the big toe towards the 2nd toe. Some common signs and symptoms include:

• A bony bump developing on the inside or top of the big toe, which can become red and swollen
• Joint stiffness, loss of motion within the joint
• Deep, aching pain within the joint which worsens with footwear
• Difficulty fitting in shoes
• Most common in women
• The 2nd toe starting to become misshapen

Bunions can be classified into stages

• Stage 1 (mild)
• Stage 2 (moderate)
• Stage 3 (severe)

Pain can occur at any stage, however, the more advanced stages are more commonly associated with pain and difficulty fitting into footwear. As you can imagine, as the big toe drifts over closer and closer to the 2nd toe, the lump becomes larger, more painful and footwear options become more difficult. Other forefoot complications also become more common as the smaller toes become impacted as well.

The Role Of A Podiatrist In Bunion Management

A podiatrist’s role is to conservatively manage a bunion. This means the podiatrist will assess your bunion, your foot, gait, the severity of your condition, and go through the conservative, non-operative treatment options. 

Some common treatments for bunions include:

• Custom orthotics – help offload areas that are being overloaded and worked, help realign the foot and prevent the toe from further drifting inwards.
• Exercises to help improve the strength of some of the smaller muscles around the joint.
• Footwear advice – assess your footwear and give you appropriate advice to reduce bunion progression and pain
• Joint mobilisation – involves using hands-on therapy to help improve the joint range of motion.

If pain persists and you’ve exhausted all conservative treatment options, then it would be feasible that your podiatrist will refer you for a surgical opinion.

Bunions are a very common complaint and presentation seen in our clinic. If you’re suffering from pain or just worried about your feet and don’t want your bunion to worsen, feel free to contact us here at The Footcare Clinic as we can fully assess your issue and work with you to find the best solution.