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Bunions: Symptoms and causes


The term ‘bunion’ refers to a bony bump at the base of your big toe. While many people will be familiar with what a bunion looks like, not many people know what the causes and symptoms of a bunion are. In our latest blog post, Mr Amit Amin, Consultant Orthopaedic Foot and Ankle Surgeon, takes a closer look.

What is a bunion?

A bunion is a bony bump that forms on the joint at the base of your big toe. It occurs when some of the bones in the front part of your foot move out of place.

The bump is in fact the first metatarsal bone, which has drifted inwards, and this makes the big toe drift outwards towards the smaller toes. The bump sometimes gets bigger over time and can cause pain, redness and difficulty wearing shoes. Pain in the ball of the foot under the smaller toes is very common, and this is due to transfer of pressures. The smaller toes can also become deformed over time.

What causes a bunion?

The cause of bunions is largely unknown, however there is often a strong family history. Whilst we see bunions principally in females, they can also affect men.  Having more mobile joints in general and flat feet often accompany bunions. Wearing tighter shoes and high heels for long periods, does not cause bunions, but can certainly make them grow in size and become more painful.

Sometimes bunions are mistaken for arthritis in the big toe joint. With arthritis the joint usually grows in size and a bump is noted – more so on the top rather than the inside of the joint. We would normally start by arranging standing x-rays of your foot – which will show us the extent of the deformity and the presence or not of arthritis.

How is it treated?

Treatment starts with trying to accommodate the bump by using wider fitting shoes.  Insoles can help particularly in patients with flat feet. Physiotherapy can be helpful to strengthen the muscles in your foot, and higher up the leg, which can make bunions less painful. Bunion devices such as separators are commonly available, but can be difficult to wear for long periods and in some cases can make pain worse.

What other treatment options are there?

If the above management fails, surgery is then discussed to correct the bunion. This is a day case procedure, usually under general anaesthetic but can also be performed under local anaesthetic/sedation. The procedure involves resetting the 1st metatarsal bone back to its original starting place. This involves cutting it and fixing in the correct position with screws. (picture?) Success rates are very high however it can 6-9 months time to make a full recovery. (how much more detail?)

You can find out more about bunion surgery at Parkside here. Book an appointment with Mr Amin here or by calling 020 3944 1213.


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