A bunion (also called Hallux valgus) is a deformity that forms at the base of the big toe joint.
It forms its bulge-like shape when the big toe (or hallux) moves at an angle towards the second toe.
In more severe cases of deformity, the big toe can even overlap with the second toe.
Bunions are often painful due to the irritated and inflamed big toe joint (metatarsal head).
Making it difficult walking and uncomfortable to wear normal shoes.
Studies show most cases begin with seeing changes to one foot initially. Later graduating to both feet if left untreated.
1. Hereditary (Genetics and Bunions)
The majority of population studies have found bunions to appear more so in females.
Although the strength of evidence of hereditary causes of bunions is decreasing.
Meaning, that just because your parents or grandparents had them doesn’t mean you will develop them.
There is stronger evidence when genetic prevalence is paired with footwear factors.
Meaning your genetics may only play a small part in the problem. It’s more about the shoes worn over the long term.
But! There is something you can take from your genetics.
This is – the way your foot is structured genetically. Within the world of Podiatry, this is referred to as your biomechanics.
There are increasing studies that correlate flat feet (pes planus foot type) with the risk of developing bunions.
This can be the case because there is a higher chance of hyper-mobility in the mid-foot.
To simplify the meaning, flat feet are more often flexible.
When a foot is flexible the bones in the foot are easily able to flatten under bodyweight forces.
Causing the middle of the foot to flatten and restrict the big toe joint (first metatarsophalangeal joint).
When the big toe joint is restricted it is unable to bend enough. When you restrict a joint that needs to move. The body fights by trying to modify the joint to deal with the pressure. In this case, that’s a bunion!
The big toe joint needs at least a 65-degree bend to propel your foot off the floor to get ready to take the next step. So, when the joint is locked it meant it is under stress and unable to function well.
So, the joint starts to move and thicken as a way to combat the stress. To us, that is a bunion, but it is a defence mechanism for your body.
When you understand the movement necessary for the foot to function well. You can understand how anything causing constriction and restraint will cause the foot to compensate.
This is the case with footwear. Wearing tight, constrictive footwear such as pointed shoes and high-heeled shoes.
Your foot needs to strike at the heels and then shift your body weight through your arches to the tip of your big toe joint.
The small toe box area of these types of shoes restricts the big toe from functioning well.
Think about it.
The big toe joint is big so that it can function to withstand your body weight and move you forward. If the footwear restrains the function at the hallux (big toe) joint.
Your body weight will need to be absorbed by the hallux joint because it cannot transfer to the tip of the toe, as the forces should be transferred for optimal foot function.
Hence the deformity begins to form into a bunion.
By reading this far, hopefully, you know more about the reasons bunions form. So, the best way to prevent a bunion is to act as soon as you notice changes.
In the early phase of bunion (hallux valgus) formation, you may or may not experience any pain or discomfort. The bunion generally starts eliciting pain as the deformity becomes more prominent.
There is a strong belief amongst podiatrists that custom orthotics can help.
They are scientifically proven to help in preventing the bunion from deforming further.
An orthotic device works by preventing the foot from pronating (flattening).
Providing arch support so the big toe joint can reach the angle of flexion (bend) it needs.
Because the big toe joint can reach a sufficient degree of flexion (or bend) the toe can transfer the weight to the tip of the toe.
Prevents the joint from jarring which then prevents the need to compensate by deforming into a bunion.
In suggesting custom orthotics for bunions, they will not completely reverse the appearance of the bunion.
Custom orthotics can take care of the functional cause and slow down and prevent further deformation of the big toe joint.
Since a foot in restricted and tight-toe boxed shoes causes constriction is it the opposite that a podiatrist will often recommend.
It is recommended that the shoes worn more often are more supportive to the rear-foot and mid-foot but can allow the big toe to bend freely.
Thus, any shoes that do not fit into this category are recommended to be worn only occasionally.
If bunion treatment is sort-out in the early phases you can slow down and even halt the bunion from getting worse.
However, if a bunion has deviated and deformed to the point where the toe can not function with manual help. Then, surgical options are often sought out.
Because the prevalence of bunions is so high throughout the year it has created many treatment options on the market. Some that work some that don’t work so well. We’ll address the most popular avenues. Including bunion exercises, splints/correctors, orthotic devices and surgery.
Some studies have suggested bunion exercises are helpful in the reduction of pain.
Regularly stretching and strengthening the foot is thought to provide the foot with more range of motion.
Though the studies are not conclusive and more extensive research is necessary for stronger evidence.
The limitations with strength and exercises are that they don’t often address the root biomechanical causes. Hence, they may help with pain reduction but not conclusively with preventing the progression of a bunion deformity.
There are various exercises you can try by clicking here
If you’re looking for a type of bunion corrector. This is the closest thing to it. A custom orthotic will help correct a bunion from the root cause of the issue. That is to free up the joint to move again.
There are more supportive studies on the significant effects of a custom orthotic device. As the association between flat feet and the development of a bunion is more widely recognised.
A custom orthotic provides the optimal functionality of the whole foot.
Wearing orthotics is the best way to treat bunion pain without surgery.
By increasing the functionality of the great toe (1st metatarsophalangeal joint) as you are weight-bearing.
Meaning, that you are avoiding irritation as you are actively on your feet.
Surgeons have developed a multitude of operative methods to treat bunions. For those with underlying conditions such as rheumatoid and psoriatic arthritis. At the most progressed phases of deformity surgery is at times even necessary.
Bunion surgery is agreeably the most effective way to treat the appearance of a severe bunion.
The major problem with surgical methods is the risk of recurrence of a bunion as well as the unknown aftermath.
Furthermore, post-surgery may include stiffness along the joint. Which may then lead to transfer metatarsalgia and neurological problems.
The best method is always in the angle of prevention. Preventing it from the position it is right now and making sure the deformity doesn’t progress to getting worse.
Soon as you notice changes in your feet it is always encouraged to have your concerns addressed early on. There are many ways a practitioner can test out the best outcome for you.
You have to get started before the progression of a bunion costs more than a custom orthotic.