ORTHOPEDIC CONCERN

Bunions

Also called: bunion, bunions

A bunion, medically known as hallux valgus, is a change in the shape and alignment of the big toe joint. The big toe gradually moves towards the smaller toes while the joint at its base becomes more prominent, sometimes causing pain, swelling and difficulty wearing certain shoes.

TYPICALLY OCCURS

Genetics, foot structure, joint changes and footwear pressure

TREATED BY

Bunion surgery, orthotics, footwear changes and pain management

ALSO LINKED TO

–

Why it happens?

Bunions develop when the bones at the front of the foot gradually move out of their normal alignment. Rather than simply being a lump that grows on the side of the foot, a bunion represents a structural change in the big toe joint. The big toe begins to angle towards the second toe while the first metatarsal shifts in the opposite direction, creating the characteristic bony prominence on the inner side of the foot. As the alignment changes, pressure around the joint can lead to redness, inflammation, tenderness and discomfort.

Genetics and inherited foot structure are important contributors. Some people inherit characteristics such as foot shape, joint flexibility or biomechanics that make bunion development more likely. Certain forms of arthritis and other conditions affecting the joints or connective tissues can also contribute. Bunions are more common in adults and can gradually become more pronounced over time, although the speed of progression varies significantly between individuals.

Footwear does not necessarily cause every bunion, but shoes can influence symptoms and may contribute to progression in susceptible feet. Narrow or pointed shoes can squeeze the toes together, while high heels increase pressure towards the front of the foot. As a bunion becomes more prominent, footwear may rub against the joint and cause additional irritation. Changes in the position of the big toe can also place greater pressure on neighbouring toes and the ball of the foot, potentially contributing to corns, calluses or other toe deformities.

How far along is it?

Early

The big toe begins to angle slightly towards the second toe, and a small prominence may appear at the joint. Symptoms may be minimal or occur mainly when wearing tight shoes.

Moderate

The change in alignment becomes more noticeable. The joint may become painful, swollen or irritated, and finding comfortable footwear can become increasingly difficult.

Advanced

The big toe becomes significantly displaced and may overlap or push against neighbouring toes. Persistent pain, stiffness and difficulty walking or wearing normal footwear may develop.

What addresses it?

Treatments that address this

Bunion removal→

A bunion does not necessarily require treatment simply because it is visible. Professional assessment becomes worthwhile when pain is persistent or recurring, footwear becomes difficult to tolerate, or the bunion begins interfering with walking, exercise or normal daily activities.

It is also worth seeking advice if the deformity appears to be progressing, the big toe is pushing significantly against other toes, or corns, calluses and other pressure-related problems are developing. Severe pain, sudden swelling or significant redness around the joint should be assessed, as these symptoms can sometimes have causes other than a bunion.

Quick Questions:

What causes bunions?

Bunions usually develop through a combination of inherited foot structure and changes in the alignment and mechanics of the big toe joint. Footwear and certain joint conditions may also contribute to symptoms or progression.

Can wearing tight shoes cause bunions?

Tight or narrow shoes are not considered the sole cause of bunions, but they can place additional pressure on the toes and aggravate an existing bunion or increase discomfort in someone who is predisposed to developing one.

Do bunions get worse over time?

Bunions can gradually progress, although not everyone experiences the same rate of change. The big toe may become increasingly angled and symptoms can become more noticeable as the joint alignment changes.

Can a bunion go away without surgery?

Non-surgical measures can often reduce pressure and manage symptoms, but they do not usually reverse the underlying structural deformity. Surgery is the main method of correcting the position of the bones when a bunion is severe enough to justify operative treatment.