Podiatrists Treating Bunions


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Bunions are probably one of the most commonplace ailments of the foot here in the UK, and their treatment comes under the specialty of podiatry, a field devoted to managing and caring for conditions of the foot. In this article we look at bunions and how they are treated by podiatrists.

What are bunions?

Bunions are also referred to scientifically as hallux valgus, a condition where the big toe (the hallux) is deformed in such a way that it sticks out to the side. As bunions worsen, the hallux begins to turn inwards towards its neighbour, the second tow, causing pain and tenderness. Bunions are typified by a large lump on the side of the joint of the big toe, and this is usually either a protrusion of bone or a swollen part of the joint called the bursal sac.

The symptoms of bunions include: Irritated skin around the joint of the hallux, pain whilst walking or running, reddening and pain of the joint of the big toe, and the aforementioned movement of the big toe inwards towards the second toe. These signs are fairly characteristic and are easily diagnosed by both doctors and podiatrists.

The condition can make walking unpleasant, or in some cases, painful, and can pose difficulties when it comes to fitting footwear. Sufferers will often have to find a shoe in a larger size to accommodate the protrusion typical of bunions, and ill-fitting shoes can cause other problems with the foot in the long term.

Bunions are largely caused by genetics, the cellular code which determines all of our body’s properties and functions. The condition develops when the structures within the big toe are arranged in a manner that leaves them vulnerable to injury, and gradually, the movement of the joint typical of bunions. These structures are the ligaments (bone to bone linkages) and tendons (bone to muscle linkages) around the bone of the big toe.

Bunions also tend to form as a result of other deformities or conditions of the foot like flat footedness. These conditions change the way we walk, and thereby place undue pressure on our joints, causing deformities like bunions.

Ill-fitting shoes is thought to be a major cause of bunions as well, although it is unclear as to whether this factor needs to occur alongside genetic issues for bunions to form.

How do podiatrists treat bunions?

Bunions can benefit from a number of different podiatric treatments, and which method best suits a particular case very much depends on the individual. A podiatrist will need to assess the big toe and foot as a whole to make recommendations on the best course of treatment. If there is an underlying cause responsible for the bunion, then your podiatrist will want to address that as well.

Orthotics are a standard method of podiatric treatment that can have a remarkable effect on bunions. They are usually recommended alongside resting and icing the affected joint, and are typically advised as treatment for milder cases. Orthotics are usually specially designed insoles prepared by your podiatrist to cushion your foot, and thereby alleviate pain.

In some cases surgical measures are needed to relieve severe bunions. These can be performed by podiatric foot surgeons who will need to have attained the necessary qualifications. These procedures can take a number of different approaches to treating the bunion, including:

  • Realigning the bone of the big toe to correct deformity.
  • Removal of the protrusion typical of bunions, which is usually either bone or an inflamed bursal sac.
  • Realigning the cushioning between bones of the big toe (cartilage).
  • Repositioning any bones associated with the toe responsible for the bunion.
  • Modification of the metatarsal bone (the bone of the big toe), which can be lengthening, shortening, lowering, or raising the bone.

These procedures are usually quite straightforward, and can be formed under local anaesthesia. The surgeries are extremely effective, although they are still avoided if more conservative treatment through orthotics will suffice. It will usually take about 8 weeks for the foot to recover after surgery, and during this time it will be advised that you avoid placing weight on the foot (crutches are advised).

If your bunions are severely affecting your ability to walk, then the necessary podiatric treatment will be available through the NHS. If you would like to treat the bunion through other means then private podiatry is available across most of the country.


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