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Bunions
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Overview
What Are Bunions?
A Bunion (also known as “hallux valgus”) is a deformity affecting the joint that connects the big toe to the foot ( the “first metatarsophalangeal joint” – or “MTP” joint). The 1st MTP joint is critical for bearing and distributing our body’s weight when we’re on our feet. Although many think the bony protrusion at the base of the big toe is due to a bony growth, it is actually due to the misalignment of the joint as the big toe bends towards the second. The joint often becomes stiff, inflamed and painful. The outward protrusion of the joint can also make it difficult to find proper-fitting shoes.
Bunions are common: they affect about 23% of adults and occur more frequently in women than men. A bunion is a progressive foot deformity, meaning they usually form slowly over time. It is also irreversible without surgical intervention, although surgery is only indicated if it significantly disrupts one’s quality of life. For most people, conservative routes of treatment will suffice to manage pain and slow down the progression of the bunion and to prevent other painful disorders, like bursitis and arthritis.
When a bunion affects the joint at the base of the little toe, it’s called a “bunionette”.
Symptoms
What Are The Symptoms Of Bunions?
Bunions are a progressive disorder and develop slowly over time. Signs and symptoms include:
- The big toe pointing or bending inward toward the other toes. This is often the earliest symptom: it starts as a small deviation but gradually grows over time.
- The base of the big toe sticking outward more than usual.
- A prominent bony bump at the base of the big toe
- Irritation and redness of the skin around the bunion.
- Inflammation and stiffness around the joint
- Pain when walking or when pressure is applied to the bunion
- Reduced range of motion or movement in the 1st MTP joint of affected foot.
Causes
What Causes Bunions to Form?
Any one (or a combination) of the following factors can cause or contribute to bunions.
- Genetic predisposition, whether it be bunions in particular, foot shape and structure, or joint-related diseases (i.e.: arthritis)
- Wearing overly tight, pointy or narrow shoes
- Wearing high heels
- Flat arches
- Activities that place excessive pressure and strain on the toes and joints at their base, such as ballet or running
- Natural joint wear and tear
- Rheumatoid arthritis.
While they may be beautiful, those beloved fancy high heels may be why bunions are more prevalent in women than men: the joint at the base of our big toe carries up to 60% of our body weight when walking and up to 3 times our body weight when jogging or running. When we wear high heels or repeatedly squeeze our feet into ill-fitting footwear, even more weight is put on that joint, which can trigger a bunion to form if we’re predisposed to them.
Once a bunion develops, narrow or tight fitting shoes will squeeze and put more pressure on the joint, which causes the bunion to grow.
Treatment
The goal of treating bunions is to resolve foot pain so that you can resume normal activities. The deformity itself cannot be fully corrected without surgery; however in most cases bunions can be effectively managed by conservative, non-surgical methods. Such treatments include:
- Footwear Modification: This involves avoiding tight shoes that squeeze the toes, and high heels. You may also opt for an orthotic or special shoe that can accommodate the width of the bunion.
- Anti-inflammatory medication: This reduces joint inflammation and relieves pain. Such medications include Ibuprofen, or any other non-steroidal anti-inflammatory drug (NSAID).
- Bunion splints: These are usually made of medical grade plastic and are strapped onto the big toe and midfoot. They are designed to straighten out the MTP joint and hold it in place.
- Bunion aligner: This is a thin sleeve worn over the foot which makes it great to wear during the day in normal shoes. As the name suggests, it works to realign the big toe and bring it back to its natural position, without taking up too much room in your shoe.
- Therapeutic taping: The joint is taped to help keep it in place, prevent further misalignment, and temporarily manage pain and inflammation.
- Shoe stretching: A foot specialist can stretch your shoes where additional room is required, which will relieve pressure on the bunion without altering the overall size of the shoe. This will allow you to keep your favourite shoes
- Supportive insoles or custom orthotics: Supporting collapsed arches and correcting faulty foot mechanics as well as poor foot alignment can help to slow down the progression of bunions.
- Bunion exercises: These exercises are very easy to do at home. They help to strengthen foot muscles to better support and stabilize the joint, ultimately decreasing pain caused by bunions.
All of these treatments are available in our foot clinic.
To treat your bunions, book a foot assessment with one of our chiropodists using our online booking form below, or call us at 416-769-3338 – no referral required! Our foot clinic is open Mondays to Fridays from 9am to 6pm, and Saturdays from 9am to 4pm.
Risk Factors
What Increases My Chances of Getting Bunions?
The following risk factors and activities can make one more vulnerable to developing bunions:
- Genetics: This includes the shape and structure of your feet (which is hereditary), or any hereditary joint-related diseases (i.e.: arthritis)
- Wearing overly tight, pointy or narrow shoes
- Wearing high heels
- Flat arches
- Age – people over 65 are more susceptible to developing bunions due to the natural wear and tear of our joints over time.
- Being overweight
- Ballet or physical activities that place excess pressure on our toes and the joints at their base.
- Spending excessive time spent on our feet (i.e.: jobs that require you to stay on your feet, such as nursing and teaching).
- Rheumatoid arthritis.
Prevention
How Do I Prevent Bunions?
The most effective and practical thing you can do to prevent bunions is wear proper footwear. You can do this by:
- Avoiding wearing high heels (or at least restricting them to special occasions)
- Avoiding wearing narrow, pointed shoes that put excessive pressure on the big toe joint
- Wearing shoes with good arch support and a wide toe box
- Wearing motion control and stability shoes when running long distances to reduce the biomechanical forces that contribute to bunions
It’s important to remember: there is no need to sacrifice your feet for fashion. You may love the shoes, but if they don’t love you back, the relationship may not work out. The specially curated selection of shoes and custom dress shoe orthotics at Feet First are living proof that you can be stylish and kind to your feet. After all, you deserve shoes that love you as much as you love them.
If you already have bunions, you can prevent the condition from getting worse by:
- Using protective and supportive devices, such as splints or orthotics, which help position and realign the foot. A foot specialist or chiropodist at our Clinic can help you find the device that works best for you.
- Getting footwear that accommodates and properly fits the bunion, which reduces pressure on the joint and gives it a chance to heal and improve.
The knowledgeable foot specialists at Feet First Clinic can help you find bunion-friendly shoes, sandals and boots that suit the unique shape and biomechanical needs of your feet. Book an appointment with a chiropodist today if you want to seek treatment for bunions or to determine if you may be at risk of developing bunions based on your family history, gait patterns, and foot alignment.