Podiatry Insights - Bunions

Bunions are arguably the foot and lower limb positional abnormality that is most often seen as a presenting complaint to podiatry clinics.  Medically, bunions are referred to as a hallux abducto valgus deformity and are often characterised by a deviation of the big toe towards the other toes of the foot and the prominence of a lump at the metatarsophalangeal joint which eventually hardens over time. The condition is seen in both men and women, however women do make up a large majority of symptomatic bunion cases that require intervention. The condition itself often leads to restricted and/or painful range of motion of the big toe joint which is essential in the proper functioning of the feet during the gait cycle. By altering the halluces ability to flex upwards during the propulsion phase of gait, bunions can ultimately alter the method of propulsion and thus, the gait cycle itself. Bunions by themselves can be either symptomatic or asymptomatic but will generally also affect a person’s ability to find properly fitting footwear as well as affecting the cosmetic appearance of their feet.
There are many factors identified as causative in bunions, some within a person’s control others out of it. Research supports the idea that no single factor can be pinpointed as being a primary cause of bunions forming, but rather, a combination of factors may result in bunions forming. The following factors have been shown to contribute to the formation of bunions:

• Genetic inheritance
• A persons predisposition to developing bunions can be controlled by their genetic makeup.
• Tight or narrow footwear
• Wearing excessively tight or narrow footwear exposes toes to compressive forces which over time results in permanent deviation of the hallux toe joint to a position that results in the formation of a bunion.
• Foot injury or trauma
• Arthritis (osteoarthritis, rheumatoid arthritis or psoriatic arthritis).
• Ongoing abnormal biomechanics
• Excessive pronation of the feet alongside tight muscular structures (such as the gastro-soleus and intrinsic foot muscles) can contribute to overloading of the medial aspect of the hallux toe joint and consequential deviation of the toe joint.
• Lifestyle factors
• Occupations that require extended periods of weight bearing can cause excessive pressure through the feet which can cause unstable foot joint positions that gradually adopt to a more permanent bunion position.

Bunions come in different shapes and sizes, as well as different severity of symptoms. The mildest forms usually involve a small lump which may be red, with mild deviation of the hallux joint. The severest bunions involve complete subluxation of the hallux joint with possible overriding or underriding of the 2nd digits. The severity of the deformity will direct the necessary course of action to be taken.
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There are a number of treatments options available to assist in settling down existing bunion pain as well as preventing further complications. Some of these possible treatments involve:

• Avoiding tight fitting or ill-fitting shoes. Focus on wearing shoes that have adequate space in the toe box and do not compress the toes themselves.
• Applying ice for 10 minutes every day on the inflamed joints to ease discomfort.
• Wearing a bunion brace or splint.
• Correcting altered biomechanics with orthotics.
• Wearing a bunion cushion.
• Using anti-inflammatories to reduce pain associated with bunion pressure.
• Surgical advice on correction of bunion abnormality as a more permanent solution.

Podiatrists are able to assess your bunions through a biomechanical assessment and tailor make a treatment protocol to your requirements. Proper diagnosis and treatment approach is vital to help reduce current symptoms and prevent symptoms from getting worse. If you or anyone you know has concerns about bunions, contact us at Health Associates for an assessment.

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​Dr Anel Kapur delivers an outstanding clinical podiatric care to all clients. He has earnt himself an exceptional reputation among his clients for his attention to detail, gentle approach and depth of knowledge.
Dr Anel Kapur is available for appointments Monday and Saturday.
Bookings are available online or contact reception on 9542 3330 ​

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