FOOT & ANKLE

Bunions (Hallux Valgus)

Bunions are a painful bump that is an extra bone and fluid filled sac which develops on the inside of the foot at the big toe (metatarsophalangeal - MTP) joint. They are associated with hallux valgus, a condition where the big toe drifts towards the smaller toes and the outside of the foot. Bunions are usually slow to develop, more common in women than men and tend to develop in those who have a family history. Bunionettes, like bunions develop in the same way however are less common and occur on the outside of the foot.

Symptoms

In addition to the visible protrusion on the inside or outside of the foot, symptoms of bunions may include:

  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • Callus or corn on the bump
  • Stiffness and restricted motion in the big toe, which may lead to difficulty walking
  • Change in the shape of the foot



Causes

The major cause of bunions is prolonged wearing of poorly fitted shoes that are tight, narrow and high heeled which compress the toes and exerts excessive pressure while walking. The condition worsens over time and becomes more painful as the bump grows in size. 

Other causes include:

  • Foot injuries
  • Inflammatory condition e.g. rheumatoid arthritis or neuromuscular condition such as Charcot-Marie-Tooth or polio.
  • Misalignment of bones in the feet



Diagnosis

Diagnosis is made by medical consultation and examination, taking the patient's past medical history and physically inspecting the feet. An X-ray may be requested for further diagnosis to identify the cause of the bunion, severity and determine treatment. 



Treatment Options

Non Operative Treatment

Once formed, bunions and bunionettes are permanent unless surgically removed. However at the earlier stages, to avoid further development and manage pain non operative treatment measures may include:

Changing footwear to roomier, more comfortable shoes

Padding or protective silicon on the inside of your shoe to help cushion the area over the bunion

Ice packs to help reduce pain and swelling

Pain killers (paracetomol or panadol osteo) and anti-inflammatories if tolerated and not contraindicated

Orthotics, toe spacers and in some cases a splint at night to help realign the foot


Surgery

Where non operative treatments are ineffective, surgery may be recommended with the goal to relieve pain by realigning the bone, ligaments, tendons and nerves so the big toe can be brought back to its correct position. Osteotomy is a common type of bunion surgery that involves the surgical cutting and realignment of the bones around the big toe. Dr du Sart chooses to perform minimally invasive (keyhole) bunion surgery for most of his patients. 


Find out more about Bunion Surgery.

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