You can’t help but notice a bunion – that large, bony-looking growth where the big toe meets the main part of the foot, with the big toe pointing towards the other toes rather than forwards.
If you think you might be developing a bunion – or already have – there are steps you can take to help slow down the process. We ask podiatrist Lorraine Jones, member of the Society of Chiropodists and Podiatrists, about the causes of bunions and how to prevent their development.
Causes and symptoms
A bunion is caused when the first metatarsophalangeal joint (the one at the base of your big toe), becomes unstable and moves out of place. As a result you end up with a deformity on the outer edge of that joint on your big toe. You may have pain or discomfort, swelling, redness and changes to your foot shape.
There are two main causes:
You can inherit a predisposition to having a bunion, but there are other factors too. Women tend to have the worst bunions because, if you’re wearing shoes that exert pressure onto the forefoot – which is basically any female-styled shoe, such as slip-ons and narrow-toed shoes – that exerts pressure on the metatarsophalangeal joint.
The combination of this inherited tendency and choice of footwear often exacerbate the problem.
Steps to prevent bunion development
There are simple steps that you can take to prevent a bunion developing further. Prevention is the best solution, and if you have spots signs of trouble, it’s important to take action sooner rather than later.
If you’re wearing flat shoes, like ballet-pumps, and your feet pronate (roll in when you walk), it will make your condition worse.
• Look for footwear with a moulded foot-bed inside the shoe, preferably with a low heel. You also need plenty of toe room, so choose shoes with rounded toes. Some women buy shoes that are a size too small, because they are so used to their toes touching the sides of the shoes. You should be able to wiggle your toes comfortably.
• The other feature you should look for are shoes that have laces or a Velcro strap across the instep, to stop your foot sliding forward. If you buy a slip-on, even though they may be fairly flat, you’ll be sliding forward with every step you take. This will mean that the joints and toes will experience gentle trauma, which can exacerbate the problem over a long time.
• Get good trainers and sandals can also be a good choice. But you must choose a trainer that’s designed to help a foot perform well in sport. These will help to support your foot and give good shock absorption.
Orthotics & splints
You don’t have to spend a fortune on them. There are lots of low-cost orthotics that you can buy over the counter if you know that you pronate.
A podiatrist will examine your feet, identify the problem, and tell you whether you need orthotics. “They can also help you decide whether you need a splint. These are devices that help to keep your big toe in a straight line.” says Lorraine.
“One type has a splint that gently keeps the toe pulled out straight, bends where the big toe joint is, and has a strap that goes over and around the mid-foot to stabilize it. The splint is hinged over the big toe joint so that you can wear it while walking.”
When should surgery be considered?
Surgery is an option if your bunion is painful or affecting your life in other ways.
‘You need to think carefully about this option as it can take six to eight weeks to recovery, and you will probably need crutches and an ortho-boot to help you walk. An operation can work well, but I would always try different footwear and treatment with orthotics and splints first. If you choose to proceed, do your research and choose someone with a good history of foot surgery.”
Bunions - NHS factsheet
For more information on bunions or general foot care, visit our musculoskeletal centre. Or if you a specific query, ask one of our experts who can provide you with more information.