Bunions

What are bunions?

A bunion is an abnormal enlargement of the joint at the base of the big toe, often (but not always) accompanied by movement of the alignment of the big toe so it no longer points straight ahead but towards the other toes.

Although they're more common in older people, they can begin at any age, and even children can develop them.

A similar bump, but on the outer edge of the foot at the base of the smallest toe, is known as a bunionette.

Symptoms

Anything that forces the big toe into an incorrect position causes the joint to stick out. It gets rubbed, irritated and becomes red, swollen and inflamed. The bone may actually enlarge, too. A vicious cycle develops - the more it sticks out, the more damage is caused, and so on.

Causes and risk factors

Bunions and bunionettes are caused by biomechanical abnormalities - factors that put unusual strain on the tendons and ligaments which hold the bones of the feet in place.

Bunions and bunionettes can run in the family, but more often than not it's poorly fitting shoes or high heels, which put abnormal pressures on the feet, that are responsible.

The big toe gets forced inwards and the toe joint rubs against the shoe. In the long term, the joint is likely to be affected by painful arthritis.

Treatment and recovery

Prevention is certainly better than cure, since once a bunion starts to develop it won't correct itself - even if you don't wear shoes. The tendons running to the toe bones will have been displaced, and pull across the joint, instead of correctly lying directly over it.

Shoes that have a wide front and low heel are essential. Podiatrists or chiropodists can provide advice about suitable insoles and pads that fit in between the big and second toes to help keep the big toe straight.

The only real cure is surgery, but it isn't a particularly pleasant operation and the bunion often reappears.