Bunions: what they are, causes and treatment

What causes bunions? 

The causes of bunions are not fully known, but some factors can lead to their development.

Family history

It is believed that genetics play an important role in the development of bunions. Certain hereditary characteristics can influence foot structure and joint stability, thus increasing the risk of developing bunions.

Structural foot deformities

Some structural foot deformities can lead to the development of bunions, such as flat feet or high arches . These characteristics can alter the distribution of body weight on the big toe joint, increasing pressure in the region.

Wearing improper footwear

Frequently wearing tight or high-heeled footwear can put excessive pressure on the big toe joint, leading to the development of bunions. This type of footwear can press toes together and force the big toe to deviate from its normal position.

How are bunions diagnosed? 

Bunions are diagnosed by an Orthopaedic surgeon. To determine the diagnosis and assess the extent of the deformity, the physician may apply the following procedures:

Physical examination

The Orthopaedic specialist will examine the foot and big toe joint to check for a bony growth. The physician will also assess if there is pain, swelling, redness, sensitivity and calluses around the bunion.

X-Ray

The physician may prescribe X-rays to analyse the bone structure and severity of the deformity. Usually, weight-bearing foot X-rays (MCDT Standard) provide the necessary information to confirm the diagnosis, such as bone position, angle of the joint and other changes in the joint.

How are bunions treated? 

The treatment for bunions varies according to the severity of the symptoms and the functional impact on daily life. In mild to moderate cases, conservative treatment methods can be effective. In severe cases, when the symptoms are intense or foot function is impaired, surgical intervention may be necessary.

Conservative bunion treatment

Conservative treatment includes the following options:

• Proper footwear. Patients are advised to wear proper footwear that is comfortable, spacious and has a wide toe area. Shoes should not cramp the foot, to avoid putting pressure on toe joints.
• Insoles and orthotic devices. The use of insoles and orthotic devices can help distribute weight on the foot more evenly and provide added support, helping reduce discomfort and stabilise the joint.
• Physiotherapy and exercises. Strengthening the muscles and performing specific foot exercises can help improve joint stability and mobility, relieving symptoms and delaying the progression of bunions.
• Medication. In cases of pain and swelling, the physician may prescribe anti-inflammatory drugs or painkillers to temporarily relieve symptoms.

Surgical treatment for bunions

When conservative treatment is not effective or the bunion deformity is severe and substantially affects the patient’s quality of life, surgery may be considered. 
Bunion surgery aims to correct the deformity, realign the bones and restore the foot’s normal function. The intervention can involve open or percutaneous surgery, depending on the severity and angle of the bunion, the presence of arthritis (or other related pathologies) and joint mobility. 
The intervention can be performed on an outpatient basis, and the patient can be discharged within 24 hours after surgery. The latest anaesthetic and pain management techniques make these procedures quicker and less painful, rendering bunion treatment less aggressive and invasive.