If you’ve been noticing a big, bony bump at the side of your big toe, then you may have a bunion. If your bump is on the side of your little (fifth) toe at the forefoot, you may have a bunionette (tailor’s bunion).
Medically known as Hallux Abducto Valgus (HAV), the term ‘bunion’ describes a bony bulge that can develop over time on the inside of the big toe. The bulge is caused by a malaligned position of the big toe joint where the long bone (metatarsal) moves out towards the other foot, and the connecting toe (phalanx) bends in on it, toward the other toes.
Bunions tend to worsen in ‘stages’ and become more prominent progressively. As they do, the ligaments and tissues surrounding the joint stretch and contract accordingly, ultimately leaving it in a fixed position. Bony and arthritic changes can also occur within the joint. This means that bunions have different characteristics at different stages and the right management needs to be decided on a case-by-case basis.
Anything that places greater pressure through the big toe joint, like pointed shoes, maybe a potential contributing factor. Often bunions can run in the family, are more prevalent in women than men, and are thought to be linked with an unstable function at the big toe joint. Other contributing factors include:
The biggest sign is the change in the appearance of the big toe joint. You may also experience:
As the bunion progressively worsens, the big toe may push into the lesser toes. Over time, the toes may begin to overlap.
As bunions progressively worsen over time, starting treatment early is the key! If you’ve started noticing your bunion developing either recently or within the last couple of years, now is the best time to take action. Treatment may include:
As bunions are often associated with other foot problems, treatment will also address any underlying issues that are identified. If the symptoms or the deformation is not reducible, surgery may be indicated.