A bunion is a protuberance
of bone or tissue around a joint, usually at the base
of the big toe but can also occur at the base of the
little toe (“bunionette” or “tailor’s
bunion”). It is often associated with the big
toe deviating at an angle (“Hallux Valgus”)
and a widening of the angle between the 1st and 2nd
metatarsals (long bones which connect to the toes).
Bunions are often
painful to various degrees and the skin and deeper tissues
around a bunion can also be swollen, red or inflamed
and painful. Because of the big toe pushing in toward
the lesser toes, the other toes can be indirectly affected
by a bunion: the smaller toes may overlap, develop corns
and become bent and toenails may begin to grow into
the sides of the nail bed.
When walking, many people have their feet
rolling in (also called “excessive pronation”).
When the foot pronates, excessive weight is put on the
big toe and its joint when the foot pushes off. Over
time the joint becomes bigger to cope with the added
bunions are caused by arthritis or trauma (fractures
or breaks into the joint). Footwear is not the common
cause as generally promoted but is only a contributing
factor: when wearing high heels, the person’s
weight is not distributed over the whole foot but nearly
only over the ball of the foot and especially on the
Women tend to develop bunions more than
men because proportionally their feet have to carry
more weight than men. Similarly, overweight people will
more easily develop bunions.
Bunions can run in a family but are not
hereditary as it is the biomechanical structure that
is hereditary and passed through the family.
cannot be reversed, except through surgery. They can
only be relieved by custom
orthotics (also called “arch supports”)
which neutralize abnormal foot pronation and reduce
the load on the forefoot area. Proper weight distribution
and biomechanical activity are re-established which
may prevent or reduce the gradual growth of a bunion.
Sometimes surgery (“bunionectomy”)
may be indicated when a bunion is at a tertiary stage,
orthotics must be worn after surgery to prevent
any reoccurrence. For the custom orthotics to be effective,
it is necessary to wear them between 75 and 80% of the
time when weight bearing.
For any questions about flat feet, orthotics,
or our treatment procedures, give
us a call.