Bunions

What are bunions?   

Bunions, also known as Hallux Valgus, are a common foot condition characterised by a bony bump formed at the base of the big toe. The condition is caused by structural weakness within the foot, causing bones in the front part of the foot to shift out of place. In turn, this shift pulls the big toe towards the smaller toes, causing the joint to protrude. You can also develop small bunions on the joint of your little toe called bunionettes.   

What are the symptoms of bunions?  

While the appearance of bunions can be bothersome, you may not experience any symptoms from the condition. However, as bunions progress, the implications of the condition extend beyond aesthetics and may affect your overall quality of life. The signs and symptoms of bunions, beyond the protruding bump, include:   

  • Swelling, redness or pain   
  • Corns or calluses (thickened skin)  
  • Stiffness or restricted movement in the big toe, which may lead to difficulty walking  

What are the risk factors for developing bunions?   

Despite the common misconception, bunions are not caused by wearing high heels or ill-fitting footwear. Although wearing inappropriate shoes can exacerbate the condition, it has been found that the two primary risk factors include being female and having a family history of the condition. Women are disproportionately affected, being approximately nine times more likely to develop bunions than men.   

How are bunions managed and treated?   

Non-surgical treatment  

When bunion symptoms start impacting your quality of life, there are different external treatment options available. These include: 

  • Over-the-counter pain relief   
  • Footwear modifications, including wearing wide toe box shoes  
  • Inserts such as toe spacers  

While conservative treatments can help relieve pain, improve function, and may delay or prevent the need for surgery, they do not provide a permanent cure for bunions. Surgery should only be considered if conservative methods fail to provide relief.  

 

Surgery  

If you are experiencing persistent bunion pain, the first step is to consult your GP or a physiotherapist. They can refer you to an Orthopaedic Foot and Ankle Consultant that can look after the condition. Imaging tests, such as X-ray, are usually required to examine the full extent of the condition. If appropriate, your consultant can outline the most suitable type of surgery for you, utilising the most up to date open and minimally invasive techniques to remove the bunion and realign your toe.

The above content was reviewed by Mr. Shane O'Neill, Consultant Orthopaedic Foot & Ankle Surgeon at Mater Private Network in Dublin.