Bunions are estimated to affect up to 23% of 18 to 65-year-olds, and 35% of those aged over 65 years.
A bunion is a bony bulge that can develop on the inside of each foot at the big toe joint. This bulge is actually your big toe joint (first metatarsophalangeal joint) in a displaced position, with the big toe turning inwards to face the other toes, and the connecting long bone (first metatarsal) moving outwards. The big toe joint may also undergo structural changes that see it become stiff, painful, and further deformed, adding to the magnitude and protrusion of the bunion.
Generally speaking, bunions are caused by forces being applied to the foot that push the toe inwards over a period of time. The most common cause of this force is repeatedly squeezing the feet into tight, narrow, pointed or otherwise inappropriate footwear over a period of time. This is likely why older women develop bunions at a greater rate than men, though research has shown that other factors aside from tight footwear are also often when bunions develop.
Your foot structure and biomechanics can make you vulnerable. This is particularly true if you have flatter (pronated) feet, which can see your foot rolling downwards for longer periods during every step. If that’s the case, the pressure through your feet can drive the big toe down into the ground with more force, pushing on the toe and encouraging the development of a bunion – particularly when your foot posture isn’t supported by good shoes or orthotics.
Instability and hypermobility at the big toe joint can also make you vulnerable, and bunions do tend to run in families (hereditary factors) as the shape of the metatarsals can also play a role. Other contributing factors include the amount of time spent on your feet, having arthritis and other medical conditions.
While the biggest symptom of a bunion is the notable bony protrusion, you may also experience some redness, swelling, stiffness and pain around the joint. If your bunion continues to rub against your shoes, you may also develop some callus or corns on the side of the bunion.
Bunions tend to get progressively worse over time, especially if they’re never managed. Initially, the joint may be flexible and you may be able to straighten the toes with your fingers. Over time, your bunion may stiffen and become fixed in its new position. Bunions tend to affect both feet because the causes tend to be symmetrical, but can definitely affect only one foot or affect both feet at different rates. Here’s a great illustration of the stages from thewisefeet.
As bunions only worsen over time if left unmanaged, getting to them early to halt or slow their progression is key. We start our care of your bunion here at Masterton Foot Clinic with evaluating the current status of the bunion and which stage it’s at. One of the main factors that influence which treatment is best for you is whether your bunion is still flexible, or has become rigid in its position.
We’ll assess your gait and biomechanical characteristics, the factors that are continuing to place abnormal forces on your big toe, and will create your treatment plan to address these. This may include one or all of: