What is it?
A bunion is the common name for a medical condition known as Hallux Abducto Valgus (HAV). It is an abnormal bony prominence on the inside of the foot at the big toe joint. It may be painful, swollen or red. A bunion usually develops in stages. First the big toe drifts towards the second toe. Added bone then develops and the big toe joint enlarges. The big toe may eventually curl over or under the second toe.

What causes bunions?
There is no single cause of HAV, but it develops over time in association with a number of risk factors. Contrary to popular opinion, shoes with high heels or narrow toe boxes do not cause a bunion, but they exacerbate existing signs and symptoms and can put normal feet in a position where they are predisposed to HAV developing.

Factors that predispose to developing HAV:

• Poor foot biomechanics including excessive pronation (rolling in) of the foot, high or flat arches, immobile ankles, restricted big toe movement.
• Injury to the area- spraining or dislocating the big toe joint.
• Inflammatory joint disease such as rheumatoid arthritis or gout
• Systemic conditions that lead to ligament laxity
• Neuromuscular conditions that result in high arch or flat arch feet such as cerebral palsy, polio or Charcot Marie Tooth disease
• Incorrect footwear- while technically not a cause

What can be done about it?

Your podiatrist can offer a wide range of options available depending on the level of symptoms and extent of the deformity:

• Shoes- wear wider fitting shoes with a round toe box and laces/buckles to fasten the foot inside the shoe.
• Padding- used to relieve pain and pressure
• Strapping
• Hot or cold therapy
• Cushioning Insoles
• Exercises
• Orthoses- can correct the biomechanical abnormalities and reduce the further development of deformity
• Surgery