A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.” Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.
Symptoms, which occur at the site of the bunion, may include: Pain or soreness, Inflammation and redness, a burning sensation, possible numbness Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.
Non-surgical treatments for bunions may include: Wearing shoes that fit and that have adequate toe room. Stretching shoes professionally to make them larger. Putting bunion pads over the bunion to cushion the pain. Avoiding activities that cause pain, such as being on your feet for long periods of time. Taking over-the-counter pain relievers when necessary, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen. Using ice to provide relief from inflammation and pain. Using custom-made orthotic devices.
Surgery might be recommended if non-surgical treatments fail to provide relief, and you are having trouble walking or are in extreme pain. Surgery can be used to return the big toe to its correct anatomical position. During surgery, bones, ligaments, tendons, and nerves are put back into correct order, and the bump is removed. Many bunion correction procedures can be done on a same-day basis. The type of procedure will depend on your physical health, the extent of the foot deformity, your age, and your activity level. The recovery time will depend on which procedure or procedures are performed. Surgery may be recommended to correct a tailor’s bunion, but is unlikely to be recommended for an adolescent bunion.
One-hundred and ninety-seven participants responded who were predominantly women of European descent, aged between 46–65 years old, from the North Island of New Zealand. The majority of participants identified with having either rheumatoid arthritis (35%) and/or osteoarthritis (57%) and 68% reported established disease (>5 years duration). 18% of participants had been issued with therapeutic footwear. Walking and athletic shoes were the most frequently reported footwear type worn regardless of the time of year. In the summer, 42% reported wearing sandals most often. Comfort, fit and support were reported most frequently as the footwear features of greatest importance. Many participants reported difficulties with footwear (63%), getting hot feet in the summer (63%) and the need for a sandal which could accommodate a supportive insole (73%). The survey respondents were predominately women of European descent, aged between 46–65 years old, from the North Island of New Zealand. The majority reported having RA (n = 65, 35%) and/or OA (n = 106, 57%), and 68% (n = 125) reported having established disease (>5 years duration). Nearly half (n = 88, 48%) were in employment, 40% were retired and 16% were unemployed or involved in voluntary work. Over two thirds (n = 125, 72%) of respondents did not receive regular podiatric care, although 67% (n = 116) had been previously prescribed with insoles or orthotics from a health professional. Further, 18% of participants had been issued with therapeutic footwear from a private organisation contracted by the New Zealand government to provide footwear and orthoses to high-risk patients. Of those provided with therapeutic footwear, nearly one third (n = 9, 29%) reported that they do not wear their prescribed footwear and 45% (n = 14) reported that they wear only them occasionally.