A bunion or Hallux Valgus refers to the condition in which the big toe is angled excessively towards the second toe, rather than pointing forwards in a straight line. Over time, this excessive angle gives the appearance of a ‘bump’ on the inside of the big toe joint. This bump is called a bunion.
The bunion may appear red and swollen. Sometimes they cause pain, this depends on the type of footwear being worn, the amount and type of activity a person does and how excessive the big toe is pointing towards the second toe. Thick, hard skin (callus) or corns may appear over the bunion due to excessive pressure from footwear. It may be difficult to find footwear that is wide enough to accommodate the enlarged joint.
There are a number of reasons a bunion may occur. The main cause is often shoes that do not fit properly. Tight, narrow, high heeled shoes cause great strain on the big toe joint. Due to this style of shoe commonly being worn by women, this makes the condition more common in women than men. There is evidence to suggest that bunions run in families, often due to an inherited biomechanical problem. Bunions can be caused or made worse by arthritis in the joint.
If you have a bunion then an assessment by a podiatrist, physiotherapist or an orthopaedic surgeon may be necessary. Often bunions can be managed conservatively, though some may require a referral for surgical correction.
Over time, bunions usually become larger and more painful. It is difficult to predict how fast this will occur. Certain types of activity should be reviewed and an alternative form of exercise may be preferable. High heeled, poorly fitting shoes should also be avoided as these can exacerbate symptoms.
There is a danger that the smaller toes may be affected as a result of a bunion, due to the malalignment of the big toe joint. They may change shape or start to overlap. A fluid-filled space called a bursa may also develop under the skin over the bunion which can be painful. Early conservative management can help to slow the progression of the condition, though surgery may be the preferred option to resolve the problem.
Advice about suitable footwear can be provided by a podiatrist which may help to slow the progression of the condition and make it more comfortable. Corns or callus that may appear over the bunion can be removed by a podiatrist. Silicone gel appliances can be provided to cushion and protect the bunion. If these conservative treatments provide an inadequate level of relief, a surgical referral will be required.
