Bunions: symptoms, causes, and treatment options


A new minimally invasive keyhole surgery for bunions is now available in the UK.

Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Rhalou Allerhand

If a painful lump has developed on the side of your foot that just won’t budge, it sounds like you might have a bunion. More than 15 million people in the UK suffer with bunions and they are a common foot problem. But can you remove them completely and what are the best bunion treatment options?

From shoe stretchers to keyhole surgery, we speak to Consultant Orthopaedic Surgeon Dr Andrea Bianchi and Orthopaedic Surgeon David Gordon about the best bunion treatment options:

What are bunions?

Bunions are bony bumps that are usually prominent on the inside of the foot by the big toe joint.

‘A bunion, medically known as a Hallux Valgus, is a deformity of the foot that forms around the base of the big toe,’ says Dr Bianchi.

‘Bunions are very easy to spot, and you’ll know that you are suffering from them when you see a bulging lump on the side of your foot and your big toe leans against your second toe.’

What causes bunions?

The three main causes of bunions are thought to be genetics, pregnancy and footwear. ‘This means if members of your family suffer from bunions then you have a much higher chance of developing the painful condition,’ says Dr Bianchi.

‘Tight fitting shoes can cause bunions to form as they put more pressure on the toes causing the bunions,’ adds Dr Bianchi.

The three main causes of bunions are thought to be genetics, pregnancy and footwear.

‘If you are genetically predisposed to bunions, then wearing shoes like this can cause them to form at a much more rapid rate. Wearing high heels do not cause bunions but they can exacerbate the problem, as they cause your body weight to sit at the front of your foot.’

Common bunion symptoms

Bunions are a swelling along the inner side of the foot, usually at the base of the big toe. ‘Bunions can result in hard, callused and red skin which occurs when the big toe and second toe overlap,’ says Dr Bianchi. ‘They can also cause chronic pain, swelling and redness over the joint of the big toe.’

‘For many patients the pain can be particularly bad after wearing tight fitting shoes such as high heels,’ he adds. ‘For lots of people suffering from bunions this means that they can no longer wear the fashionable, high-heeled shoes that they want to.

‘Some people suffering from arthritis may also experience restricted movement of their big toe.’

When to see a doctor about bunions

Many people with bunions don’t experience any problems at all. ‘Bunions often don’t require any kind of medical treatment,’ says Dr Bianchi, ‘but if the pain is having an impact on your quality of your life, then treatment might be the right option for you.’

If you experience any of the following, Dr Bianchi recommends you book a consultation with a specialist:

  • Continuous pain.
  • Decreased movement of your big toe.
  • If you have problems finding shoes that fit you properly.

Lifestyle tips to minimise bunions

While you can’t prevent bunions completely, there are a few things you can do to minimise discomfort and avoid aggravating them.

‘If you are suffering from painful bunions, then I would recommend wearing wide shoes with a low heel and soft sole, bunion pads to reduce rubbing and regular painkillers to ease the discomfort,’ says Dr Bianchi.

If you are genetically predisposed to bunions, then it is best to avoid wearing high-heels.

Unfortunately it’s not great news for shoe lovers. ‘If you are genetically predisposed to bunions, then it is best to avoid wearing high-heels and tight-fitting shoes,’ he adds.

Bunion treatment options

If you don’t experience any discomfort or pain, then chances are you don’t need to do anything. However if you do have any negative symptoms, there are a number of non-surgical options you can try before considering surgery. Gordon recommends the following:

  • Modify or change your footwear

The most important first step to minimise discomfort, opt for a soft, wider shoe without a heel, which accommodates the foot well.

  • Try shoe stretchers

These may increase the shoe width to accommodate the bunion.

  • Invest in bunion pads

Often made from silicon rubber, bunion pads protect the prominent area from rubbing.

  • Use silicon spacers

These can prevent toes rubbing if placed between the first and second toes.

Bunion surgery explained

If non-surgical options fail to resolve your symptoms and you want to get rid of your bunions for good, surgery is your best option.

‘In the past, surgery involves a general anaesthetic, invasive and painful surgery and recovery can be up to six weeks and many people are told to avoid exercise for up to six months,’ says Dr Bianchi. ‘For active people who are living busy lives, this type of surgery has not been an option.’

However, a new minimally invasive keyhole surgery is now available in the UK. ‘The treatment requires only a local anaesthetic and removes the bunion quickly without the use of screws or plates,’ explains Dr Bianchi. ‘As well as this, patients can walk without crutches immediately after the procedure and are able to return to everyday activities almost straight away.’

What happens in bunion surgery?

Keyhole surgery ensures patients have a much faster recovery time and it provides the ability to restore the foot back to a normal shape.

‘The ground-breaking keyhole surgery uses only local anaesthetic and is the only treatment that doesn’t involve any fixative devices such as screws, plates or wires,’ explains Dr Bianchi. ‘During the 20-30-minute procedure 2-3-millimetre incisions are made in the skin and then small surgical burrs are used to correct the deformity and modify the bones of the foot.

If non-surgical options fail to resolve your symptoms, to get rid of your bunions surgery is your best option.

‘A series of small and precise fractures are made in the foot which do not require screws or pins to force the bone into place. Once the bones have been realigned, they are then left to heel naturally and according to the patients load-bearing needs.’

This is only one of several options for bunion surgery and your surgeon will decide which is most appropriate for your individual situation.

Net Doctor


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