What are bunions?

Bunions are bony bumps that form on the joint at the base of your big toe. They occur when some of the bones in the front part of your foot move out of place. The medical name for them is hallux valgus.

What causes them?

The exact cause of bunions is unknown, but they tend to run in families. Wearing badly fitting shoes is thought to make bunions worse. Additional contributing factors are believed to include:

• Foot stress or injuries
• Deformities present at birth
• Also a medical condition, such as arthritis, particularly inflammatory types, such as rheumatoid arthritis

What are the typical symptoms?

The signs of a bunion include:

• A bulging bump on the outside of the base of your big toe
• Deviation of the big toe over towards the little toes
• Swelling, redness or soreness around your big toe joint
• Corns or calluses — these often develop where the first and second toes rub against each other
• Ongoing pain or pain that comes and goes
• Limited movement of your big toe

How are bunions diagnosed and treated?

An appointment with your consultant to discuss your symptoms and an examination of your feet, is usually followed by an X-ray to confirm the condition.

Non-surgical treatment: to help relieve the pain and pressure of a bunion:

• Changing shoes - wearing roomy, comfortable shoes that provide plenty of space for your toes or getting customised shoes
• Toe spacers or realignment splints
• Padded insoles
• Painkillers or anti-inflammatory medication
• Applying ice - icing your bunion after you've been on your feet too long or if it becomes inflamed can help relieve soreness and swelling. If you have reduced feeling or circulation problems with your feet, check with your doctor first before applying ice

Surgical options: if conservative treatment doesn't relieve your symptoms, you might need surgery. Surgery is not recommended for cosmetic reasons; only when a bunion causes you frequent pain or interferes with your daily activities.

There are many surgical procedures for bunions, and no one technique is best for every problem. Surgical procedures for bunions can be done as single procedures or in combination. They might involve:

• Removing the swollen tissue from around your big toe joint
• Straightening your big toe by removing part of the bone
• Realigning one or more bones in the forefoot to a more normal position to correct the abnormal angle in your big toe joint
• Joining the bones of your affected joint permanently

Recovery

It's possible that you'll be able to walk on your foot right after a bunion procedure, however it’s important that you stay off your feet as much as possible for at least two weeks. To prevent a recurrence, you'll need to wear proper shoes after recovery. Your consultant will discuss in more detail what you can expect after bunion surgery.

Work – it depends on the type of job you have, however you may need to stay off for between six to 12 weeks, your consultant will advise you on when you should return.

Driving - avoid driving for six to eight weeks.

Exercise - avoid sports and strenuous exercise for up to six months.