What is it?
A bunion, or a hallux abducto valgus deformity, is a deformity characterized by medial deviation of the first metatarsal and lateral deviation of the hallux (big toe). It is often erroneously described as an enlargement of bone or tissue around the joint at the head of the big toe.
What Causes It?
There is some disagreement about the cause of bunions. Some see them primarily caused by long-term use of tight-fitting shoes with pointed toes. Others believe the problem stems from genetic factors exacerbated by shoe use. (It is interesting to note that in a survey of people from cultures that do not wear shoes, no cases of bunions were found, lending credence to the hypothesis that bunions are caused by ill-fitting shoes.)
Bunions occur when pressure is applied to the side of the big toe (hallux) forcing it inwards towards, and sometimes under or over, the other toes (angulation). As pressure is applied, the tissues surrounding the joint become swollen and tender. The tell-tale bump itself is partly due to the swollen bursal sac or a bony anomaly on the metatarsophalangeal joint. The larger part of the bump is a normal part of the head of the first metatarsal bone that has tilted sideways to stick out at its top.
Bunions develop when the pressure of bearing and shifting one's body weight bears unevenly on the joints and tendons of the foot. This imbalance in pressure makes the big toe joint unstable, eventually molding the parts of the joint into a hard knob or bump jutting out beyond the normal shape of the foot.
(It is interesting to note that in a survey of people from cultures that do not wear shoes, no cases of bunions were found, lending credence to the hypothesis that bunions are caused by ill-fitting shoes.)
How Can I Treat It?
Bunions may be treated conservatively with changes in shoe gear, an insole such as Superfeet to accommodate padding and shielding, rest, ice and medications.
These treatments will address symptoms more than they correct the actual deformity. Surgery may be necessary if discomfort is severe enough or when correction of the deformity is desired. If this is your option, please refer to our Medical Referral page.