Bunions are one of the most common forefoot deformities. A displacement of the bone under the big toe occurs, which causes the big toe to move towards the smaller toes. This shifting of the bones causes a bony prominence on the side of the patients foot (the bunion joint). Over a period of time the big toe may come to rest under (occasionally over) the 2nd toe.
Causes of Bunions
- The most important causative factor is poor fitting footwear, such as too short or pointed toe shoes. This accounts for a higher incidence among women than men.
- Family history of bunions.
- Abnormal foot function, excessive pronation (excessive rolling in of the foot at the ankle joint while you are walking).
- Poor Balance.
- Ankle stiffness.
- Big toe stiffness.
- Rheumatoid or osteoarthritis.
- Muscular imbalance.
- If the ligaments in the feet are very weak.
- In some cases, bunions can occur due to trauma or injury to the feet.
- Include redness, swelling & pain which may be present along the inside margin of the foot.
- The patients feet may become too wide to fit into their normal size shoe & may experience moderate to severe discomfort when the patient is wearing tight shoes.
- Corns & calluses may occur on the soles of the feet, in between toes & on the bunion joint.
- Stiffness can occur at the big toe due to secondary arthritis, this is known as Hallux Rigidus.
- Other foot conditions can occur such as ingrown toe nails & in severe cases the bunion joint may have a fluid filled sack called a bursitis This can be very painful & can become infected.
Firstly Consult with a Podiatrist or a Physiotherapist to have the area assessed.
- Proper fitting shoes.
- Improve foot function such as balance.
- Fix stiff ankles by joint mobilisation to regain range in ankle joint to reduce compensatory pronation.
- Improve range of movement in big toe joints by joint mobilisation.
- Correct muscular imbalance with an exercise programme designed by the Physio or Podiatrist.
- Custom Orthotics or innersoles can help reduce further progression of the bunion.
- If your bunion becomes painful, red & swollen, try using ice on the joint & elevate the foot on a stool.
- Bunion Night Splints & exercises can reduce the size of the bunion or prevent further progression of the deformity.
- In some cases surgery, might be necessary. Post-surgical rehabilitation with your Physiotherapist involves addressing pain & swelling & some of the contributing factors such as faulty biomechanics & muscle imbalance. Orthotics after surgery may assist to prevent the bunion returning.