Bunions (hallux valgus)
A bunion is a swollen bony bump on the joint at the base of your big toe, where the toe drifts towards the other toes. Podiatry care, including footwear advice, padding and orthotics, can reduce the pain and pressure. Fiona assesses bunions in an initial consultation from $100.
What a bunion is
A bunion is an enlargement of the joint at the base of the big toe. The big toe bends towards the smaller toes, and the joint at its base sticks out and swells. The medical term is hallux valgus. Over time a bunion may be accompanied by dislocation of the big toe joint and, in many cases, pain.
Symptoms
A bunion tends to announce itself through the shape of the foot and how shoes feel.
- The base of the big toe is swollen and sticks out.
- The big toe bends towards the other toes, sometimes pushing the second toe to overlap the third.
- The skin over the big toe joint is red and sore.
- Thickened skin forms at the base of the big toe.
- Shoes feel painful, especially narrow ones.
- Walking becomes painful or difficult.
Other problems can develop around a bunion, including arthritis in the affected joint, hammer toes, callus, corns and ingrown toenails.
Causes and risk factors
Bunions can run in families because foot shape is inherited. Poor biomechanics and bad foot posture can raise the risk of developing them. A person with flat feet or heavily pronated walking patterns is more likely to develop bunions than a person with neutral feet.
Other factors can contribute, including bone length discrepancies, poor foot positioning, hormonal changes, tight or uncomfortable footwear, and heavy use of the big toe joints.
Treatment at the clinic
Most bunions are treated without surgery. Fiona assesses your foot posture and walking pattern in a biomechanical assessment, then treats you herself at every visit. She may fit custom orthotics from $650, which include the assessment, fitting and a review appointment, or semi-custom orthotics from $450. Strapping, taping, padding and footwear advice may help reduce the pain of the bunion in your shoe. Stretching and strengthening programs may be given when they suit your foot.
Referral for X-ray, ultrasound or MRI can be arranged when the diagnosis needs it, and referral back to your GP when surgery for a severe bunion needs discussing.
Looking after it at home
Start with your shoes. Shoes that are wide enough to avoid pressure on the bunion are the first step, so look for wide insteps and broad toe boxes. Avoid high heels. A protective bunion pad can cushion the joint inside the shoe and reduce rubbing.
When to see a podiatrist
See a podiatrist when the bunion is painful, red or swollen, when shoes are hurting, or when walking becomes difficult. See one early if you have flat feet or bunions run in your family, because foot posture can be checked before the toe drifts far. Your GP is the right person to see about surgery for a severe bunion, and about any medicines for pain.
Questions
Can a bunion be fixed without surgery?
Most bunions are managed without surgery. Wide shoes, padding, orthotics and taping can reduce the pain and slow the drift of the toe. Fiona assesses your foot and recommends the simplest option first.
Do orthotics help bunions?
Orthotics may help by improving your foot position when walking, which matters when you have flat feet or pronation. Fiona makes custom orthotics from $650 or semi-custom orthotics from $450, both including a biomechanical assessment.
Do bunions run in families?
They can, because the inherited shape of your foot raises the risk. Poor foot posture, flat feet and pronation add to that risk, and Fiona can check your foot posture even before a bunion becomes painful.