From the Guidelines
A bunion is a bony deformity that occurs at the base of the big toe, where it joins the foot, and is characterized by a bony bump that forms due to the big toe pushing against the adjacent toe, forcing the joint to enlarge and stick out. This condition can cause persistent pain, restricted movement, and may lead to other foot problems such as hammertoes, bursitis, or metatarsalgia (pain in the ball of the foot) 1. The medical term for a bunion is hallux valgus, and it is more common in women, partly due to wearing tight, narrow shoes with pointed toes.
Causes and Risk Factors
Bunions develop due to various factors, including:
- Inherited foot structure
- Foot stress
- Injuries
- Certain medical conditions like arthritis According to the most recent evidence, people with bony deformities, such as bunions, may need extra wide or deep shoes to accommodate their condition 1.
Treatment Options
Treatment options for bunions range from conservative approaches to surgical correction, and may include:
- Wearing proper footwear
- Using padding and orthotics
- Medications for pain relief
- Surgical correction to realign the joint It is essential to note that the routine prescription of therapeutic footwear is not generally recommended, but patients should be provided with adequate information to aid in the selection of appropriate footwear 1.
Foot Care Recommendations
General footwear recommendations for people with bunions include:
- A broad and square toe box
- Laces with three or four eyes per side
- Padded tongue
- Quality lightweight materials
- Sufficient size to accommodate a cushioned insole Use of custom therapeutic footwear can help reduce the risk of future foot ulcers in high-risk patients 1.
From the Research
Definition of Bunion
- A bunion is a common complaint, particularly among older female patients, characterized by progressive deformity at the metatarsophalangeal joint, resulting in a painful dorsomedial prominence 2.
- It is also described as a prominent and often inflamed metatarsal head and overlying bursae, usually associated with hallux valgus where the great toe moves towards the second toe 3.
- Bunions can be classified into different types, including dorsal bunion, tailor's bunion, and hallux valgus (HV) 4.
Characteristics of Bunion
- Bunions are found in at least 2% of children aged 9-10 years, and almost half of adults, with greater prevalence in women 3.
- They can cause difficulties with shoe wear and contribute to falls in the elderly 2.
- Bunions can lead to painful walking and affect mobility, with more than 64 million Americans having bunions that can lead to painful walking 5.
Types of Bunions
- Hallux valgus (HV) is a type of bunion where the great toe moves towards the second toe 4, 3.
- Tailor's bunion, also known as bunionette, is another type of bunion that can be treated with percutaneous and minimally invasive techniques 6.
- Dorsal bunion is a type of bunion that presents as a painful dorsomedial prominence 4.