Bunions: Causes, symptoms and treatments
If you have a bony bump on your foot, you might have a bunion. We’ll be looking into what bunions are, what causes them and bunion treatment options available.
Most commonly found in women, bunions grow slowly over time, and can go from causing minor discomfort to difficulty walking and carrying out daily tasks.
While it’s possible to live comfortably with bunions, those with more painful bunions may look for pain remedies, and can opt for surgery to prevent complications and help with pain.
In this article, we’ll be looking into what bunions are, what causes them and bunion treatment options available.
What is a bunion?
Otherwise known as hallux valgus, a bunion is a bony bump that forms at the base of your big toe.
Beneath the joint of your big toe, soft tissue and small bones known as sesamoids work together to keep your toe straight and fixed in place. When your big toe starts to shift towards your other toes, your metatarsal – a long joint that’s connected to your big toe – moves out of place, creating a bony prominence known as a bunion.
What is a bunionette?
Bunionettes, or Tailor’s bunions, are bunions that develop on your little toe.
They’re formed in the same way as bunions are, but instead the metatarsal connected to your little toe is misaligned and juts out, forming a bunionette.
What causes bunions?
Bunions can be caused by a range of factors, with genetics playing a major part for most people. While they can’t be inherited directly, you may inherit factors that predispose you to bunions, such as loose ligaments or flat feet.
Other anatomical factors, such as rheumatoid arthritis and metatarsal structure, can also increase the chances you’ll develop bunions. Bunions can also develop after a foot injury or during pregnancy, when relaxin – a hormone that helps widen your pelvis – loosen the ligaments in your foot.
In some cases, babies are born with congenital bunions, or bunions present at birth.
Do tight shoes cause bunions?
Contrary to popular belief, tight shoes and high heels don’t directly cause bunions.
However, if you’re already predisposed, these shoes can encourage the onset of bunions, or make the symptoms of already existing bunions worse.
How do I know if I have a bunion?
You’ve noticed a bony bump on the side of your foot, but how do you know if it’s a bunion? Bunions also have the following symptoms:
- Corns or calluses
- Difficulty moving your big toe
- Pain and soreness
- Inflammation or a burning sensation
- Redness at the bunion site
- Possible numbness
You might notice these symptoms are heightened if you wear tight fitting shoes or high heels, or if you’re on your feet for long periods of time.
How to treat bunions
A bunionectomy – otherwise known as bunion surgery or hallux valgus correction– is the only way you can treat bunions permanently.
If performed through keyhole or minimally invasive techniques, the procedure involves making a small stab type incision at the site of the bunion and straightening your metatarsals, before inserting screws to hold the realigned bones in place.
Open surgery can also help using a longer incision or cut and also uses screws to bone the bone after it is cut and moved.
You can take the following steps to ease symptoms at home:
- Wear shoes with low heels, a wide front and a soft sole
- Wear orthotic insoles designed to ease bunion pain in your shoes
- Take over the counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help with pain and inflammation
- Apply an ice pack to your bunion to reduce inflammation
- Avoid high heels and narrow shoes
- Avoid standing or walking for long periods of time
- Avoid running if your symptoms are severe
- If you have arthritis in your big toe joint, a steroid injection can sometimes be helpful
What happens if a bunion is left untreated?
With mild symptoms, it is possible to go about your daily life without your bunions causing too much difficulty. You might find benefit in orthotic insoles and wearing low-heeled shoes, but can live comfortably without having to undergo a bunionectomy.
If your bunions worsen over time and are left untreated, there’s a chance you may develop the following complications.
Worsening pain
While mild bunions can be managed with painkillers and small lifestyle changes, over time your pain may become more severe, making it difficult to carry out day to day activities. This in turn can go on to affect other aspects of your life, including your social and mental health.
Changes to your gait
Any discomfort from your bunions at all can cause changes to your gait, as you shift your stance to take pressure off the affected foot. Over time, the uneven weight distribution can put more strain on your knees and hips, and you might also experience problems with your lower back.
Bursitis
When too much pressure is applied to your joints, your bursae – fluid filled sacs that cushion your joints – become inflamed, causing a condition called bursitis.
Bursitis is a painful condition characterised by a dull, achy pain and tender, swollen skin around your joints. It can be treated at home with rest, ice and painkillers, but if your symptoms worsen or don’t improve after two weeks, you may need antibiotics or a steroid injection.
Crossover toes
In severe cases of bunions, the bones in your foot might push your big toe towards your other toes, eventually forcing your big toe to cross beneath your second toe. This foot deformity can cause a persistent pain in your feet, making it difficult to walk and carry out daily activities. Some toes as they cross over can actually dislocate with the pressure of the big toe pushing on them.
Hammertoe or mallet toe
As bunions put pressure on the rest of your toes, you’re more at risk of developing hammertoe or mallet toe. Both toe deformities occur when your second, third or fourth toe is curled over at the joint, with hammertoe defined by a bend in your middle toe joint, and mallet toe by a bend in the joint nearest your toenail.
Bunions in summary
While there’s not much you can do to avoid getting bunions, there are steps you can take to manage your symptoms, making it possible to carry out your day to day activities.
However, if your bunions are causing you discomfort – or you simply want to be bunion-free – get in touch with one of our consultants to find out if a bunionectomy is right for you.
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If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.