Written by Michelle Champlin BSc Pod., M.Ch.S., S.R., Ch., (UK)
What is a bunion?
A bunion is a problem with your big toe . It happens when your big toe bends, or deviates, towards your 2nd toe. The medical term for a bunion is ‘hallux valgus’ and this translates as ‘deviated big toe’ – with hallux meaning your big toe and ‘valgus’ means when any bit of your body deviates away from the centre line of your body.
A bunion is the prominent bone sticking out from the inside of your big toe joint with the bone behind it – the metatarsal bone. The long bone (metatarsal) in the front of your foot and the bones of your toe should lie in a straight line. A bunion occurs when the long metatarsal bone angles towards your other foot but your toe bones point towards your 2nd toe of the same foot, as in the picture below.
Where do you get bunions?
Even very mild, or early stage bunions can be extremely painful. Likewise, large bunions may not cause pain, but only cause difficulties such as finding footwear that fits and doesn’t rub on the bunion. Painful bursas, or fluid filled sacs, can form over the bunion area, as the body tries to protect the bone from friction.
Bunions can appear on either one or both feet, and can range from mild to severe (podiatrists and surgeons classify the bunion in ‘stages’ of severity).
Bunions – or rather bunionettes – can also appear on the outside of your foot at your little toe and are called tailor’s bunions.
Why do bunions develop?
Bunions mainly affect women. This is thought to be mainly due to footwear, with high-heeled shoes pushing up to 95% of your body weight forward, when it should be distributed more 50-50%. Because men wear low / flat shoes with a roomy toe box that doesn’t squash the toes, they are less likely to develop a bunion.
Footwear isn’t the only factor. Bunions have a significant genetic factor and you’re more likely to develop one if your mum (or dad) had them. Bunions tend to show up with one or more other foot ‘biomechanical’ issues – such as forefoot splaying with a collapsed transverse arch, or over-pronation with a collapsed long arch. Both of these mean your muscles, tendons and ligaments of your foot are not as tight and toned as they need to be and aren’t holding the foot bones in the correct posture.
Thus, another reason for bunions, and why women are more at risk – is hormonal factors. Pregnancy hormones in particular make our ligaments, muscles and tendons more loose, sometimes leading to foot splaying and bunions.
More unusually, Mrs Champlin, Chief Podiatrist at Dubai Podiatry Centre has also seen hallux valgus in patients who have undergone cancer-fighting chemotherapy, explaining that “Chemical Induced Peripheral Neuropathy is a side effect I have sometimes seen, with symptoms in the feet like neuropathy caused by diabetes for example, of tingling, loss of sensation and muscle weakness. The muscle weakness can cause collapsed arches and bunions. We sometimes see this even in children, who aren’t commonly affected by bunions.”
As bunions tend to develop over time, from a combination of factors such as footwear, weight bearing and hormones, it is more unusual to see children develop bunions.
How are bunions treated?
There are both surgical and non-surgical (conservative) options. Surgery is not a quick-fix solution. Commonly called a ‘bunionectomy’ there are actually over 130 procedures and your specialist orthopaedic surgeon will discuss with you the most appropriate, once he has assessed your feet. You should choose a surgeon with specific expertise and interest in foot surgery and we are glad to provide referral to the best both in Dubai and internationally.
Your surgeon will explain costs, post-operative time on either crutches or wheelchair, as well as post surgical splinting or custom orthotics and appropriate footwear in order to keep his/her good work in place and to minimize risk of recurrence or complications.
The most effective non-surgical bunion treatment is custom corrective orthotics. These must be made for your feet, diagnosis and prescription by a qualified podiatrist, following a full assessment. In contrast, over-the-counter insoles from a shop or pharmacy are not designed to correct biomechanical deformities or anomalies and only provide shock absorption or cushioning. Custom orthotics can prevent the bunion worsening by offloading weight from the toe and joint. Once the joint and foot posture anchoring the toe is corrected, we can then also look at straightening the toe deviation with custom made toe props.
There are also specialist protective gel sleeves we can provide you with, to protect the bony prominence from rubbing within your footwear and causing a bursa or pain.
At Dubai Podiatry Centre, we work unlike other Podiatrists and intervene proactively with our patients to correct foot alignment where possible, achieving measurable, visible results to your foot posture and any resultant pain. We think more as engineers and have developed innovative orthotic solutions that are far advanced beyond orthotic therapy of even 15 years ago.
Whatever your job – from cabin crew in high heels for 16 hours or more, to a busy mum, there are far more advanced technologies and treatments available now, without resorting to medical footwear or large, clumsy insoles.
For our expert opinion, assessment and treatment options, contact our UK trained Podiatrists, led by Chief Podiatrist Michelle Champlin
Call: + 971 4 3435390
WhatsApp: + 971 50 355 3024
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