Bunions – Your top 5 questions answered

Aug 31, 2022

What is a bunion?

A bunion, also known as hallux valgus, is an enlarged big-toe joint that can sometimes become painful. It is usually inherited but can be made worse by wearing the wrong footwear. The alignment of the joint shifts and the position of the big toe alters over time.

Are bunions painful?

Pain can develop as a result of arthritis within the joint, but this doesn’t happen with everyone, it all depends on the type of bunion you have. A similar condition called hallux limitus reduces the amount of movement at the joint, making it more stiff and painful with certain activities such as walking and running. This can worsen over time and become difficult to manage. Your foot may be more challenging to accommodate in footwear if the increased width of the foot isn’t allowed for.

Who treats bunions?

Podiatrists are experts in all kinds of lower limb conditions. If you are concerned about bunions or pain in your big toe joint, we are a good place to start! If your Podiatrist thinks you need an x-ray or surgical opinion, we can refer you to the appropriate health professional.

How are bunions treated?

There are a range of treatment options available depending on where your pain is coming from. If the enlarged joint is rubbing on your shoes, it may be as simple as changing the style of shoe to reduce friction and pressure on the joint. A supportive trainer or lace-up shoe is often a good choice. However, if the pain is deeper within the joint (this can occur with bunions and hallux limitus), it would suggest that it’s the joint surfaces that have become irritated. This might be a transient problem and may settle over time, but if not you might want to consider orthoses (supports that fit inside the shoe) or a steroid injection.

Supports for the shoes can be helpful. I often recommend supports (orthoses) to patients as this can make a big difference in many cases. Usually, by changing the movement pattern of the feet and taking pressure or load off the big toe joint, the reduced forces allow the irritation and pain to settle. You may be advised to try ‘off the shelf’ devices or for some, custom orthoses are more appropriate. They can be transferred between footwear and are designed to be worn whenever you are active. Unfortunately there is no clear evidence to show that splinting bunions stops them from progressing. However, this is an area currently being researched and may prove to be beneficial in younger people.
For those individuals that don’t improve with supportive footwear and orthoses, having a cortisone injection into the joint can be helpful for settling the symptoms. This won’t solve the problem permanently, but when combined with other treatments, it can be very successful. The steroid is injected directly into the joint, often using an ultrasound scan to help guide the injection to the right area. Relief may be experienced for several months after allowing you to return to your activities pain-free. Your Podiatrist may refer you to your GP for an x-ray before proceeding with an injection.
If you have tried conservative treatment for your bunions, and yet you continue to experience pain that affects your activities, having surgery may be the next step. Not everyone is a suitable candidate however so it would be wise to discuss this in more detail with your Podiatrist who can then refer you to your local podiatric foot surgeon.

Will my bunions get worse?

Bunions don’t always get worse. They may be more noticeable or painful for a period of time, but then settle down. If you are having treatment for bunions or hallux limitus, such as orthoses or steroid injections, the pain may improve to a level that is manageable.

If you are struggling with big-toe joint pain or bunions, speak to us. We have a team of experienced Podiatrists that can offer a range of non-surgical treatments to help you stay active and healthy.

Call us on 01933 594444. Alternatively, to arrange an appointment with a Podiatrist online, go to our booking page here and select “Foot and Ankle Pain”

We look forward to seeing you!

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