Bunions & Hallux Valgus
A bunion, medically known as hallux valgus, is a change in the position of the big toe and the joint at its base. It can cause a noticeable bump on the inside of the foot, where the big toe joint becomes more prominent.
For some people, a bunion causes little or no discomfort. For others, it can become painful, particularly when wearing shoes, walking for longer periods or taking part in activities that place repeated pressure through the front of the foot.
At MK Orthotics in Milton Keynes, we look at how your feet function and how this may be contributing to your symptoms rather than assuming that the appearance of a bunion is the only cause of your pain.
What is a bunion?
A bunion develops when the big toe gradually moves towards the second toe and the joint at the base of the big toe becomes more prominent.
The medical term for this is hallux valgus.
The area around the bunion can become:
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Painful or tender
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Red or irritated
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Swollen
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More prominent as the condition progresses
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Uncomfortable when wearing certain shoes
The enlarged area may rub against the inside of your footwear, causing pressure and irritation.
The degree of deformity can vary considerably between individuals. Some people have a visible bunion without significant symptoms, while others can experience considerable pain and difficulty with footwear.
What causes bunions?
There is not always one single cause of a bunion.
Several factors may contribute to their development, including:
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Family history and inherited foot structure
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The shape and mechanics of the foot
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Changes in the position of the big toe joint
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Footwear that places repeated pressure on the toes
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High heels or shoes with a narrow or pointed toe box
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Arthritis affecting the foot
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Previous foot problems or injuries
Bunions can also be associated with other changes in foot posture, including flat feet.
However, having flat feet does not necessarily mean that you will develop a bunion, and a bunion can occur in people with different foot types.
Can bunions be painful?
Some people have bunions for many years without experiencing significant pain.
When symptoms do occur, pain may be felt:
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Directly over the bunion
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Around the big toe joint
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Along the inside of the foot
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Underneath the forefoot
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In the big toe when walking or pushing off
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In other toes if the bunion changes the way pressure is distributed through the foot
Shoes may become increasingly difficult to wear as the prominent joint rubs against the inside of the footwear.
Some people also develop hard skin or calluses around areas that are exposed to increased pressure.
Bunions and footwear
Footwear can be particularly important when you have a bunion.
Shoes that are too narrow or have a pointed toe box can place pressure against the prominent joint and squeeze the toes together.
A shoe with a wider and deeper toe box may provide more room around the toes and reduce direct pressure over the bunion.
The shape of your foot and the type of footwear you need will depend on your individual circumstances.
If you are struggling to find comfortable footwear because of a bunion, this can be discussed as part of your assessment.
What is a Tailor's bunion?
A Tailor's bunion, sometimes called a bunionette, is similar to a conventional bunion but develops on the outside of the foot at the joint behind the little toe.
Instead of the big toe being affected, the prominence is around the fifth metatarsal joint.
Like a conventional bunion, a Tailor's bunion can become painful when footwear presses against the prominent area.
The principles of footwear and pressure management are similar, although the location of the problem is different.
Bunions and foot mechanics
A bunion is a structural change to the foot, but the way your foot moves can also influence symptoms.
During walking, your foot needs to adapt to the ground and then provide an effective platform as you move forwards.
Changes in foot posture, joint movement, muscle function and the way pressure is transferred through the foot may influence how much stress is placed around the big toe and forefoot.
This is why we don't assess the bunion in isolation.
We look at the whole foot and lower limb to understand whether particular movement patterns may be contributing to your symptoms.
Can orthotics help bunions?
Orthotics cannot simply straighten an established bunion or remove the bony prominence.
However, for some people, an orthotic may form part of a wider approach to managing symptoms.
Depending on your individual foot mechanics, an orthotic may be designed to help influence how pressure is distributed through the foot during standing and walking.
Whether this is appropriate depends on factors such as:
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Your symptoms
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The structure and flexibility of your foot
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Big toe joint movement
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Foot posture
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Lower-limb mechanics
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Your activity levels
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Your footwear
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Any other foot or ankle problems
Orthotics are therefore not automatically recommended for everyone with a bunion.
At MK Orthotics, we assess your individual circumstances before deciding whether an orthotic is likely to be appropriate.
What about bunion exercises?
Exercises may be useful for maintaining strength and movement in the foot and lower limb, depending on your individual circumstances.
However, exercises cannot necessarily reverse the structural change associated with an established bunion.
If your big toe joint is painful or becoming increasingly stiff, it is important to establish what is contributing to your symptoms before deciding which exercises or other treatments are appropriate.
When should a bunion be assessed?
You may benefit from an assessment if your bunion is:
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Becoming increasingly painful
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Making it difficult to wear normal footwear
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Causing rubbing or pressure from your shoes
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Affecting your walking
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Associated with pain elsewhere in the foot
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Affecting your ability to exercise or take part in activities
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Becoming associated with problems in the other toes
A painful foot should not simply be assumed to be caused by the appearance of the bunion. There can be other conditions affecting the big toe and forefoot that may need to be considered.
Your bunion assessment at MK Orthotics
At MK Orthotics, your assessment is designed to understand how your feet function and how this relates to your symptoms.
Your approximately 90-minute initial assessment may include:
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Discussion of your symptoms and medical history
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Your normal activities and exercise
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Assessment of your footwear
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Examination of your foot posture
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Big toe and foot joint movement
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Muscle strength and function
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Lower-limb alignment
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Weight-bearing assessment
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Functional movements where appropriate
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Walking assessment
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Video gait analysis where appropriate
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Assessment of any existing orthotics
We can then discuss the findings with you and explain the treatment options that may be appropriate.
If orthotics are recommended, they can be manufactured specifically for your individual requirements.
If we don't think orthotics are appropriate, we will explain why and discuss other options where appropriate.
Footwear for bunions
Choosing suitable footwear is an important part of managing bunion symptoms.
Depending on your foot shape, you may find it more comfortable to choose footwear with:
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A wider toe box
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Enough depth around the toes
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Minimal pressure over the bunion
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A comfortable sole
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A shape that accommodates your individual foot rather than squeezing the toes together
If you have difficulty finding footwear that accommodates your bunion, we can discuss your footwear requirements during your assessment.
MK Orthotics also has experience with custom-made orthopaedic footwear for difficult-to-fit feet, including bunions.
Bunions and other foot conditions
Bunions can occur alongside other foot problems.
Depending on your symptoms, it may also be useful to consider conditions such as:
Having more than one foot problem is possible, so a detailed assessment can help establish which issues are contributing to your symptoms.
Why choose MK Orthotics?
At MK Orthotics, we take an individual approach to foot and lower-limb problems.
We don't prescribe orthotics simply because you have a particular foot shape or condition.
Instead, we assess how your feet move, where your symptoms occur and what may be contributing to them.
Our clinic is based in Blakelands, Milton Keynes, and our assessments include consideration of your footwear, activities and individual movement patterns.
Book a bunion assessment in Milton Keynes
If you have a painful bunion, difficulty finding comfortable footwear or symptoms affecting your walking or activities, a detailed assessment may help you understand what is contributing to your problem.
MK Orthotics is based in Blakelands, Milton Keynes.
Your initial consultation lasts approximately 90 minutes and includes video gait analysis where appropriate.