Bunions

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.

Symptoms

• 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.

Treatment  

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.