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Bunion or arthritis? | What is a Bunion? | Find Your Stride

Updated: Mar 16, 2023

What are bunions?

A bunion, also known as ‘hallux valgus’, describes an altered position of the big toe. When a bunion is present the big toe angles excessively towards the second toe leading to a bony lump on the side of the foot. A large sac of fluid, known as a bursa, may also appear (not everyone gets these), and this may become inflamed and sore. Often patients and even some healthcare professionals can confuse an enlarged arthritic big toe joint with a bunion. Careful consideration of the name is helpful to avoid this, 'Hallux' refers to the big of great toe, while 'Valgus' describes it's position i.e. the joint sticking out and the toe turning in. If the toe remains straight but you have a hard, bony lump on top or at the side, you probably have arthritis at the big toe joint (I'll write another post on this soon).


What causes them?

Bunions are most often caused by changes to the mechanical structure of the foot, this can be genetic or in some cases influenced by medical history, footwear or even activity. Certain foot types make a person more prone to development of a bunion. Poorly fitting footwear will generally aggravate a bunion as tight or narrow footwear squeezes the forefoot, crowding the toes together and exacerbating the underlying condition, causing pain and deformity of the joint. Bunions can also lead to crossover of the toes (the big toe sits underneath the second and/or third toe, lifting it up), which can cause pressure on the top of the lifted toes from footwear. Once the big toe begins leaning inward, the muscles and tendons that act on it no longer pull the toe in a straight line, so the problem tends to get progressively worse. Bunions are often associated with corns and calluses developing given the changes mentioned above and the pressure points created between toes and from rubbing footwear


Who gets them?

Although anyone can get a bunion, they tend to be more common in women, possibly due to some of the more restrictive footwear typically worn (more than 15% of women in the UK suffer from bunions). Women also tend to have looser ligaments (known as hyper-mobility). If your parents or grandparents have them, you may also be more prone to developing them.


Are they serious?

Some people have large bunions that are painless but cause difficulties with footwear, while others have relatively small bunions that can be very painful. Although some treatments can ease the pain of bunions, only surgery can correct the position. In some cases, pressure from the big toe joint can lead to a deformity in the joint of the second toe, pushing it toward the third toe and so on.


What are the treatments?

Your podiatrist may recommend the following:

  • Exercises

  • Orthoses (special devices inserted into shoes)

  • Shoe alterations or night splints which hold toes straight during sleep (helps to slow the progression of bunions in children)

These are all conservative measures and although they may help relieve symptoms there is no evidence they can correct the underlying deformity. Your podiatrist will be able to identify whether you need a referral for surgery, which can involve a combination of removing, realigning and/or pinning of the bones.


Once referred, your surgeon will evaluate the extent of the deformity. The aim of surgery is to address the altered position of the toe/joint. As with all surgery, there are risks and complications, so it is not usually advised unless your bunions are causing pain or are starting to deform your other toes.


How can I prevent them?

Wearing shoes that fit well is a good preventative measure, if you notice a bump developing where your big toe joins the foot, it may be time to switch your footwear. Try to opt for wider shoes that provide your toes with room to move and keep your heel height to no more than 4cm for maximum comfort. The following also serves as a useful guide:

  • Avoid backless, high-heeled shoes. Backless shoes force your toes to claw as you walk, straining the muscles if worn over a long period

  • Vary your heel heights from day to day, one day wearing low heels and the next day slightly higher heels

  • If you want to wear a heel every day, keep heel heights to 4cm or less

  • Wearing a shoe with a strap or lace over the instep holds the foot secure and helps stop your foot sliding forward

  • Calf stretches to counteract the shortening of the calf can help to keep feet supple


When should I contact the podiatrist at Find Your Stride?

If you experience any foot care issues that do not resolve themselves naturally or through routine foot care within three weeks, you should seek the help of a healthcare professional.

If you have any questions and would like to speak with podiatrist (also known as a chiropodist) at Find Your Stride click here to get in touch or book a free telephone call.


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