An average person takes around 3.5 million steps a year. This is why foot problems are so common. A bunion is a foot problem that affects about 1% of the population. Bunions are a modern foot-wear related disease, and rare in populations that don’t wear shoes. Anyone can have a bunion, but they’re more common in women than men. This may be due to the style of footwear that women wear.
What are bunions?
A bunion also known as hallus valgus refers to a condition, your big toe deviates from its natural position toward the second toe and a bony lump develops on the side of the joint of your big toe. Smaller bunions can also develop on the joint of your little toe as well, but are not as common, these smaller bunions are often referred to as a bunionette.
Causes of bunions
Bunions often develop due to increased pressures on the joint of the big toe that causes the toe to deviate towards the midline, and forces the joint away from the midline. Wearing tight, restrictive shoes that put that exerts pressure on the joint of the big toe (such as when wearing high heels with narrow toe) is thought to be a major cause. In many cases, bunions are associated with gout, osteoarthritis, and rheumatoid arthritis. Aging, flat feet, over pronation (rolling in) at the foot, and tight calf muscles are the other factors that can lead to bunions. Some studies have also suggested a genetic or hereditary factor in the development of bunions.
Signs and symptoms of bunions
In addition to the ill appearance of a deviated big toe and its restricted movement, the main problem is the pain especially in walking. Sometimes the inflammation of the joint gets worse and becomes infected. The skin in the area is typically hard, callused, and red. However, this skin and the underlying tissues may become inflamed and painful. In some cases, a bursa (fluid-filled sac) develops within the site. The second toe can become deformed and sometimes out of its place. Involvement of the surrounding nerves can cause numbness and pain in the ball of the foot and into the toes.
Treatment of bunions
Surgery is only used as a last resort in the most severe cases that do not respond to non-surgical treatments. However mild to moderate bunions are often treated very effectively by a Physiotherapist. During your Physiotherapy treatments a combination of the following treatments may be provided based on what your condition requires:
- Check suitable footwear: Well-fit, low-heeled, and roomy shoes with adjustable fastenings or laces
- Custom foot Orthotics: These devices are corrective shoe inserts to eliminate any biomechanical deficit of the foot and optimize gait pattern. They are placed inside your shoes to help realign the deviated bones and ease the discomfort and pain. Our registered Chiropodist will design Custom orthotics devices that can be molded specifically to your foot and tailored to fit exactly to it.
- Braces or Supports: This includes toes separators, bunion regulators, and bunion cushions. There are special bunion splints, for both daytime and night time used to enhance your bones’ alignment. Gelled toe spacers are also used in some cases. Silicone gel pads and bunion guards may be used to stop the friction between your foot and shoe.
- Exercises: Your physiotherapist may give you some simple stretching and strengthening exercises to strengthen your muscles and tendons around your big toe.
- Joint mobilizations: To reduce the deviation of the big toe, and increase limited range of motion in the big toe into extension.
- Taping: Helps to re-align the joint of the big toe and takes pressure off of the bunion.
- Ultrasound: Can be used in conjunction with anti-inflammatory gel such as voltaren to decrease inflammation and pain
- Massage: Used to break down callus and scar tissue around the joint
- Shockwave Therapy: Sound waves are delivered to the affected area which cause micro-traumas to the tissues and break up scar tissue and calcium collection on the side of the toe, while reducing pain.