What are Bunions (Hallux Abducto Valgus)?

To most people a Bunion means a bony bump on the side of the big toe. In reality the bunion is just one sign of a complex underlying structural deformity that can result in pain.

The condition medically is called Hallux Abducto Valgus, which simply means that the big toe (hallux) moves towards the second toe resulting in the bony bump called a bunion. This causes the foot to become broader, and the big toe joint to no longer function properly. Ultimately, this leads to discomfort and early degenerative changes (arthritis) in the joint. As the big toe moves closer to the second toe, it may result in the second toe lifting up and causing painful corns to develop.

Bunions can also occur at the base of fifth toe and these are called Tailor’s bunion’s or bunionettes.

Signs and Symptoms

The most common signs and symptoms of a bunion include:

  • Bump on the foot at the base of the big toe
  • Swelling or soreness around the joint of the big toe
  • Burning, tingling or numbness at the surrounding area of the bunion
  • Thickened skin at the base of the big toe
  • Corns or calluses
  • Chronic foot pain
  • Limited movement of the big toe
  • Difficulty wearing footwear

Causes of Bunions

Bunions typically develop when the pressure of weight bearing and walking is unevenly spread across the foot. The result of this uneven distribution is often joint instability and deformity. The most common causes of joint instability and deformity are:

  • High-heels or extremely tight fitting footwear
  • Stress caused by occupational related hazard
  • Inherited foot type
  • Foot injuries and trauma
  • Congenital deformities present at birth
  • Flat feet/over-pronation – functional abnormalities in walking patterns

Wearing overly tight shoes that squeeze the toes together is also a common risk factor for developing bunions. This is commonly seen in women who consistently wear high heels and other fashionably tight shoes such as ballet flats.

Those with a family history of bunions should be aware that it is the foot type prone to bunions that is passed down (i.e. flat feet), not the bunions themselves.

Preventing Bunions 

Once a bunion has developed, there are no effective treatments to get rid of them completely, other than surgery. However, there are many non-surgical steps we can help you take to prevent, slow or even stop the progression of a bunion. Some of the steps include:

  1. Avoid shoes with a narrow toe box
  2. If you have flat feet (over-pronated) be sure to wear supportive shoes, and if necessary, undertake orthotic therapy by a podiatrist.
  3. See your podiatrist at the first signs or symptoms of a bunion deformity, as early treatment may slow or even stop its progression.

Diagnosis of Bunions

To diagnose a bunion, our team at OnePointHealth will perform a detailed examination of your foot in the form of a biomechanical analysis. This is a comprehensive assessment to assess the characteristics of the bunion, along with any underlying causes such as gait dysfunctions.

An X-ray may also be done to confirm the diagnosis or gauge the severity of the bunion. If a bunion is found to be the cause of your foot pain, there are a variety of treatment options available.

Conservative Treatment of Bunions 

Treatment for bunion typically begins with conservative, non-surgical therapies. Some of the treatment options we recommend include:

  • Footwear modifications. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
  • Padding. Bunion pads placed over the area may help reduce pain.
  • Analgesics. Your GP can help discuss the best pain medication option. This may include non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen that can help relieve the pain and inflammation.
  • Heat or Ice.  This condition may respond better to either heat or ice. Try heat prior to exercise and Ice afterwards.
  • Injection therapy. Injections techniques may be used to treat the inflamed tissue around the joint when used in conjunction with other treatment modalities.
  • Orthotic therapy. Custom orthotic devices can help address the underlying causes and symptoms to reduce pain and progression of the condition.
  • Skin care. Removal of callus and corns help to reduce the pressure that causes the pain.

Surgery for Bunions 

As previously noted, once a bunion has developed, there are no effective treatments to get rid of them completely, other than surgery. If the symptoms of a bunion are non-responsive to conservative treatment or if the bunion has progressed past the stage where these conservative treatments are not effective, surgery may be necessary to correct alignment and remove the bunion and reduce progression.