Bunion – what to do about yours

You may be able to tell if you have a bunion by looking at your foot.

Normally your foot should be nice and straight along the big toe joint, with the big toe pointing straight ahead.

However, when you have a bunion (also known as hallux valgus), your big toe joint sticks out to the side, with your big toe pointing towards your toes. You may find it hard to find comfortable shoes and have a throbbing pain around the big toe joint when you walk.

Although less common, smaller bunions – known as bunionettes or tailor’s bunions – can also form on your little toe (pinkie) joint.

Many people can live with a bunion without any problems or complications, but for others it can be painful, and debilitating. Treatment can help.

What are the symptoms of bunions?

As well as hard lumps on the sides of your feet and your big toe joint sticking out at an angle, you may also have:

• pain and tenderness
• limited movement and stiffness in your big toe meaning you find it hard to walk
• redness or swelling around the big toe joint
• hard skin on the bottom of your foot
• squashed looking toes
• corns or calluses
• numbness in and around your big toe.

You may not have any pain or notice any symptoms, while others may find the symptoms get worse over time.

What causes it and who’s affected?

Health experts do not know exactly what causes bunions. Factors that may increase your risk of bunions include:

• getting older
• being female (or assigned female at birth)
• your genetics and a family history of bunions
• foot deformities such as having flat feet
• health conditions affecting joints, such as rheumatoid arthritis.

You may assume footwear such as high heels or badly-fitting shoes are the main cause of bunions but this is not the case. Wearing them can make bunions worse or increase your risk, but they do not necessarily cause a bunion to form.

Self-care tips

If your bunion is bothering you then there are steps you can take to help manage pain, although you can’t make bunions go away.

It helps to wear sensible low-heeled shoes, such as trainers or shoes that are roomy and fit well.

You can also take pressure off the joint by wearing arch supports (orthotics) or special bunion pads in your shoe. Toe spacers and supports (splints) can also help. Speak to your doctor or podiatrist to find out what might suit you.

If your bunion is painful then using ice packs and/or painkillers such as acetaminophen
(paracetamol) or ibuprofen (check these are suitable for you to take) can help in the short-term.

Losing weight can also help reduce the load on your feet.

Walking barefoot as much as possible can strengthen muscles in the feet, which can also be helpful.

When to see a doctor

If your bunion is affecting your daily routine and stopping you from doing things, or symptoms are getting worse despite self-care measures, then make an appointment with your doctor or podiatrist.

Always make sure you see your doctor if you are diabetic and have bunions as foot problems can be more serious.

How is it diagnosed?

Your doctor will usually be able to diagnose a bunion just by examining your foot. They will check your foot/feet whilst you are sitting and standing, and may look at how you walk barefoot.

They may also want to do an X-ray to get a clearer look at the bones in your foot.

What is the treatment?

The only way to treat the cause of your symptoms is with bunion surgery. This will only be recommended if your bunion is not responding to self-care measures and is particularly painful, getting worse, or really impacting your life. You won’t be offered surgery if it’s just to improve the appearance of your foot.

There are different types of bunion correction surgery using different techniques to straighten and realign the joint. These are:

• osteotomy – most common, where metal pins help realign the big toe
• joint fusion (arthrodesis) – joining the bones of your affected joint permanently (this may be used in people with arthritis).

What to expect after surgery

Most people are able to go home on the same day of having surgery. Recovery can take several weeks as the bone heals.

You may need crutches and guided exercises/physical therapy to help walk on the joint again, which can be stiff and painful at first.

But every case is different and some people find they are able to walk on the foot right after having a bunion procedure.

Can you prevent bunions?

It’s not always known what causes bunions but there are things that can increase your risk such as wearing poorly fitted shoes. Wearing sensible shoes that fit well and give your toes room, can help lessen your risk of bunions. Avoid pointy shoe shapes, and choose styles with a low heel.