Bunions are painful swellings that develop most often on the inner side of the foot near the base of the first toe (hallux). Less frequently, bunions occur at the base of the fifth toe (called a "tailor's bunion").
Bunions result from inflammation and thickening of the bursa (fluid-filled sac in the connective tissue) and cause abnormal bone formation and misalignment of the toe.
Bunions can be related to inflammation or to degenerative disease (e.g., osteoarthritis). They cause redness, tenderness, and pain, and alter the normal position of the first toe.
"Hallux abductovalgus" (HAV) is a term that refers to the hallux going away (abducting) from the midline of the body and twisting so the inside edge touches the ground and the outside edge turns upward. Essentially, this term describes the deviation of the toe toward the outside of the foot.
Bunions worsen over time and cause discomfort, difficulty walking, and skin problems such as corns and lesions. Sometimes, a small fluid-filled sac (bursa) near the joint becomes inflamed (called bursitis), causing additional swelling, redness, and pain.
Bunions are one of the most common foot problems. They often run in families, which suggests that the inherited shape of the foot may predispose people to them.
Pronated feet (flatfeet) are unstable and often cause bunions. Body weight is repeatedly transferred to the hallux while walking, and in flat feet, this transfer of weight allows certain muscles to become stronger than others. This overpowering of muscles causes the toe to bend and deform.
Bunions may be caused by tight, pointy-toed, or high-heeled shoes, and shoes that are too small. Women get bunions much more often than men. Improper shoes exacerbate the underlying cause of unstable flatfeet.
Treatment for bunions requires a thorough evaluation by a podiatrist. The only way to eliminate bunions is bysurgical removal. Conservative treatment usually involves applying ice to the feet for approximately 15 minutes, 3 or 4 times a day to reduce pain and swelling.
Soaking the feet in a solution of vinegar and warm water (1 cup vinegar per gallon of water) and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can also help. Due to potentially severe gastrointestinal and cardiovascular side effects, NSAIDs should only be used as instructed.
Comfortably fitting shoes are the next step. High-heeled and narrow-toed shoes should be discarded in favour of sandals or wider shoes and lower, padded heels.
Padding inside the shoe is another option, particularly if the bunion is small. Different types of pads, splints, and toe spacers are availablefrom your podiatrist to help prevent the big toe from angling outward and relieve pressure against the bunion while wearing shoes.
Most patients can benefit from a custom-molded orthotic, which keeps the feet properly aligned and stable, helping to prevent progression of the condition.
If you have bunions and you have any concerns, contact Footfit Podiatry Tauranga and we will be happy to work with you to find a solution.