What You Need to Know About Bunions

A bunion, also known as hallux valgus, is a bony bump or swelling that forms at the base of the big toe (hallux). It usually occurs when pressure placed on the big toe causes it to push against the second toe, gradually resulting in a deformity in which the big toe joint gets bigger and protrudes from its normal position.

What Are the Signs of Bunions?

Bunions develop slowly and are relatively unnoticeable in mild cases. However, it can worsen significantly if left untreated. The effects can be severe and debilitating to one’s daily life. Some symptoms to take note of are:

  • A noticeable bump at the base of the big toe
  • The big toe leaning towards the second toe
  • Redness, soreness and tenderness around the big toe and ball of the foot
  • Corns or calluses at the base of the big toe
  • Difficulty walking
  • Persistent pain, especially when wearing shoes

What Causes Bunions?

While most cases of bunions have been linked to hereditary reasons, i.e. having a foot structure prone to bunions, they are often made worse by trauma from squeezing the feet into ill-fitting shoes. Below are some contributing factors:

  • Wearing ill-fitting shoes – Footwear that are too tight, narrow, short or pointed force the toes into an unnatural position, making the foot susceptible to bunions.
  • Extended wearing of high heels – High heels push the toes against the front of the shoes, leading to overcrowding or overlapping of the toes.
  • Neuromuscular and inflammatory conditions – Illnesses such as rheumatoid arthritis or cerebral palsy often lead to the formation of bunions.
  • Heredity – Some people have a higher chance of developing bunions due to inheriting a foot structural defect such as low arches and flat feet.

Foot injuries and high-stress activities are also found to contribute to bunion formation. Additionally, women are also more prone to developing bunions than men, particularly due to their tendency of wearing high heels.

How Are Bunions Treated?

Bunion treatment comes in various forms, all of which seek to alleviate pain and relieve pressure from the big toe joint.

  • Wearing properly fitting and comfortable shoes. In some cases, the orthopaedic surgeon may prescribe custom or modified footwear suitable for the patient’s condition.
  • Medication. Over-the-counter pain relief and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Tylenol, Ibuprofen and Naproxen can help manage symptoms associated with bunions.
  • Bunion surgery. This is the only effective way of removing bunions completely and is the recommended treatment for severe cases.

When Is Bunion Surgery Needed?

Bunion surgery is recommended if the pain worsens or does not subside, or if the deformity is already too severe to resolve non-invasively. The different types of bunion surgery available are:

  • Osteotomy: Realignment of abnormally angled bone and joint in the big toe to their normal positions
  • Exostectomy: Removal of the bunion from the big toe joint
  • Arthrodesis: Replacement of the toe joint with screws or metal plates

In most cases, minimally invasive surgery is recommended. This means lesser pain, risks and downtime. Typically, patients will be able to walk slowly by themselves within a few days.

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