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Bunions

What is a bunion?

A bunion is a term used to describe a bump that forms on the outside of the big toe. This bump is the underlying bone. The medical term for a bunion is hallux abducto valgus (HAV). Smaller bunions (bunionette) can develop on the joint of your little toe.

Symptoms

  • Pain on movement, in shoes or that just comes and goes.
  • Swelling, redness and soreness around your big toe joint. 
  • Corn and callus. Rotation of the big toe to the other toes.
  • Limited movement of your toe.

Who gets a bunion?

23% of 18-65 year olds and over 35% of those over 65 years have hallux valgus. 90% women.

Why do you get it?

A bunion can take years to develop, and results from the gradual dislocation of the joint, which has become unstable when walking. The exact cause is unknown but there are many contributory factors including:

  • a medical condition such as arthritis
  • the mechanics or injuries to your foot and lower limb
  • hereditary link
  • wearing ill-fitting shoes. 

How long does it last?

Some bunions have no symptoms, and do not develop too severe. However others can lead to further possible complications:

  • Bursitis. – inflammation of the small fluid-filled pads that cushion the bones near your joints.
  • Hammertoe. Often the 2nd toe can have an abnormal bend that occurs in the middle joint of a toe, can cause pain and pressure.
  • Metatarsalgia. Pain and swelling in the ball of your foot, as your big toe stops working efficiently.

What you can do now

Conservative treatment (non-surgical) that may relieve the pain and pressure of a bunion include:

  • Changing shoes. Wear roomy, attached, comfortable shoes that provide plenty of space for your toes.
  • Padding. Over-the-counter, non medicated bunion pads, or silicone cushions may be helpful. They can act as a buffer between your foot and your shoe and ease your pain.
  • Analgesic. They can help you control the pain of a bunion, best to have a discussion with your GP. 
  • Applying ice. Icing your bunion after you’ve been on your feet too long or if it becomes inflamed can help relieve soreness and swelling. Be cautious if you have reduced feeling or circulation. 

How can a podiatrist help

  • Prescription orthotic devices. An orthotic will modify or change the forces and stresses that are placed upon tissues, this can be through encouraging or discouraging particular tissues and structures dependent on your needs. They do not realign your foot, or lower limb.
  • Exercises. 
  • Corticosteroid Injections. In osteoarthritis, they are injected intra-articularly, they increase mobility and relieve pain. 
  • Shoe alterations or night splints (hold toes straight during sleep – helps to slow the progression of bunions in children) 

Surgical options

Surgery may be an option if conservative treatment doesn’t relieve your symptoms. It is not recommended for cosmetic reasons; only when a bunion causes you frequent pain or interferes with daily activities.

There are many surgical procedures for bunions, and no one technique is best for every problem. You will need to see a podiatric surgeon or a foot and ankle orthopaedic surgeon to discuss what is right for you. To prevent a recurrence, you’ll need to wear proper shoes after recovery. For most people, it’s unrealistic to expect to wear more narrow shoes after surgery.

References:

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