Bunions ranging from none to severe
Bunions are caused by the dislocation of the big toe joint and are not a bony growth as many believe. The term bunion (or hallux valgus) is used to describe a structural deformity of the big toe joint. It describes the movement of the big toe towards the lesser toes and a movement of the first metatarsal towards the midline of the body, causing dislocation of the big toe joint. The resulting bump that can be seen is actually the joint protruding outwards due to dislocation of the joint and not any additional bone growth.
Bunions generally progress and commonly lead to arthritic changes in the big toe joint. To some degree they affect 65% of the population aged 60 and older. They can however also affect children.Bunions are generally considered to be in inherited and are passed down from parents/grandparents. Footwear is not a primary cause as many believe, it does however increase the severity of bunions and cause them to develop at an earlier age.
Bunions can often be painless, however they can often become painful due to a number of reasons. The protruding bump can rub on footwear that is too narrow. Arthritis may develop in the bunion which can cause pain even when non weightbearing.
There are a number of conservative treatments for bunions before surgery is indicated.
Mobilisation of the bunion can be beneficial in some cases, especially when bunions first begin to develop.
Orthotics may be utilised to redistribute pressure away from the bunion and help to facilitate movement in the big toe joint, particularly if the feet are flat. Footwear with adequate width is essential to prevent pressure and rubbing on the bump. Bunion shields/padding and use of anti inflammatories also provide some short term relief.
Surgery is often indicated if conservative treatments fail to provide sustained relief from pain and discomfort. There are many different procedures and surgical techniques to correct bunions, each with differing outcomes.
A tailor’s bunion or bunionette deformity is similar to a bunion on the big toe joint, except that it affects the little toe joint.
WIth a tailors bunion the little toe deviates towards the rest of the toes while the adjacent 5th metatarsal head enlarges and can move towards the outide of the foot.
Symptoms include pain, redness and swelling generally resulting from footwear irritation over the bump.
The cause is generally inherited from family or relating to foot function
Conservative treatment generally involves wearing appropriate footwear with sufficient width so as to not apply pressure and irritate the bump. Anti-imflammatories may provide some short term relief from symptomatic pain. Padding over the area may also provide some relief from symptoms by deflection pressure and friction away from the bump.
This image shows a Tailor's bunion protruding from the left side of the foot