By Emily Mildren (Podiatrist at In Stride Health Clinic in Ascot Vale)
A bunion, or medically known as hallux valgus, is the deformity of the big toe joint. It is seen as a bony lump on the side if the foot that can impact the alignment of big and lesser toes.
Anatomically it is the foots 1st metatarsal bone and 1st phalanx bone shifting at the metatarsophalangeal joint. The phalanx bone shifts towards the outside of your foot and the metatarsal bone shifts to the inside of your foot.
Bunions usually progress overtime, however they can occur at a young age (Juvenile Bunions). Due to the malignment of the MTP joint bunions can be painful, to the point where exercise, walking and standing for long periods of time becomes unbearable. The bony lump also makes the forefoot wider making it more difficult to find comfortable shoes. People with bunions also experience blistering on the area due to ill-fitting shoes. More signs and symptoms of bunions include:
- Pain and tenderness
- Redness and at times swelling
- Hard skin/callous
- 2nd toe being squashed by big toe
- Stiffness or limited movement in the big toe
Bunions can be diagnosed clinically through biomechanical assessment and through x-ray imaging. This is also to determine the severity of the bunion. Bunions that are not painful and not severe can go without any treatment. Although there are nonsurgical treatments that can help reduce pain and keep the bunion from worsening. It is to be noted that nonsurgical treatments do not reverse a bunion.
- Changes in footwear: Avoid wearing tight and narrow fitting shoes as they can cause blistering, pain and progressively worsen the bunion. Swapping for a wider fitting toe box or open toe shoe so that there is no compression on the joint and toes. Some shoes can be modified by being stretched or adding padding.
- Orthotics: People who experience pain in the MTP joint can often be helped through orthotics. Arthritis in the MTP joint in people with bunions is a common occurrence which can be assisted with orthotics as well.
- Splints and spacers: Toe spacers, that are placed between your toes can assist in reducing the progression of a bunion. Bunion pads provide cushioning the area and make it more comfortable to wear shoes.
Surgical intervention is needed after assessment and usually if the bunion is causing extreme pain and discomfort or becoming more deformed and affecting other toes. Surgery, usually conducted by a podiatric or orthopaedic surgeon can be done different ways to relieve pain and realign the bone, tendons, nerves and ligaments. Surgical intervention does require rest and no weightbearing for a period of time and should be considered when discussing treatment with your surgeon.
If you believe that you are experiencing a bunion or are having any of the signs and symptoms with your bunion then book in with one of our podiatrists to determine the best course of treatment.
As a passionate netballer Emily has a keen interest and understanding about the biomechanics in injury prevention and treatment. Emily’s other interests include foot and ankle pain, sport injuries, general nail and skin care and paediatrics – in fact, Emily became a podiatrist herself after seeing one as a child.