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Bunions

Also referred to as:
Hallux Abducto Valgus (HAV)

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What is a Bunion?

A bunion is a bony deformity of the big toe joint (1st metatarsophalangeal joint MTPJ) which leads to a prominence on the inside of the foot. Some people experience pain and tenderness over the swollen area or in the joint itself. Certain footwear can make the pain worse too such as narrow footwear or footwear with a higher heel.

You may see callus (hard skin) over the joint where it rubs on footwear and corns between the toes where they are pressed together. Many patients will also see changes to the foot shape with a progressive movement of the big toe over the top or under the lesser toes. The lesser toes get crowded and pushed towards the little toe and they can move out of line. It is common for people to find the toe next to the big toe sticks up or changes shape and develops its own corns or callus, and you can develop pain in the ball of the foot often referred to as transfer metatarsalgia or 2nd MTPJ capsulitis.

It has previously been thought that bunions (Hallux valgus) are largely genetic, however more recent evidence suggests that lifestyle factors such as wearing ill-fitting shoes or pointy/tight shoes may significantly contribute to the situation. Bunions may also be more likely to occur in people with unstable joints in the toes or mid foot and this flexibility may be inherited.

In some cases, certain health conditions, such as rheumatoid arthritis may also be responsible for the formation of bunions.

How can I help myself?

Depending on the pain and severity of the deformity there are several treatment options:

ICE therapy, painkillers and anti-inflammatory medication may be helpful. (See important safety information).

Wearing wider and deeper footwear and footwear that doesn’t come to a point around the toes may help relieve pressure. Also fastening shoes may be better than slip on shoes. See this footwear page for more information.

You can also buy gel or protective plasters/pads from most pharmacies to help to offload pressure and reduce pain.

When to see a Podiatrist?

A Podiatrist will be able to assess your foot shape and deformity and advise on the severity, prognosis and management options. Many people ask about surgical options for bunions, however there are often a lot of criteria and things to consider before going down the surgical line, and it is often not appropriate. A Podiatrist will be able to assess and advise you, and this may require referral on and imaging as appropriate to look at the bones and the underlying structure of the foot.

See this page on bunion surgery

Bunion pads, toe spacers and foot orthoses (orthotics / insoles) (which would need to be prescribed by a podiatrist) can be very helpful to reduce symptoms and should be considered along with footwear alterations in the first instance.

A bunion is a progressive deformity but it may be possible to slow down it progression or help reduce the symptoms by seeking treatment from a podiatrist.

If you book an appointment, it is wise to take the footwear you usually wear to help with the assessment and advice.

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