If you have a hard, bony bump on the outside of your big toe, you likely have a bunion. A bunion—also known as hallux valgus—develops when your bones shift out of place, creating a noticeable protrusion when your big toe is pulled in the direction of your smaller toes.
They are not only a cosmetic concern for people, they can also cause a great deal of pain and discomfort.
Bunions can form on one or both feet. Unfortunately, they grow bigger over time. The bigger the bunion, the more uncomfortable it may be to wear shoes and the more impact it will have on your activity level and quality of life.
Bunions are a progressive condition, meaning that without intervention it will get worse and more painful over time.
The bony deformity is caused when the big toe bone (metatarsal) gets pushed inwards towards the second toe, while the base of the big toe deviates outward. This shift causes a bony prominence on the inside of the foot (the ‘bunion’). Contrary to popular belief, it is not a new or extra bone growth.
As the position of the big toe shifts further, it often also causes overlapping the other toes, which can cause further pain and discomfort.
While adolescents can sometimes develop bunions, these foot deformities are more common among adults. They are particularly prevalent among older women, including women who wear shoes that crowd their toes (high heels or pointed-toe shoes, for example). Women are also more susceptible to developing bunions on account of their foot anatomy; they have lower arches, narrower feet, and a more flexible foot structure.
There are a number of causes and risk factors to developing bunions, including:
While most bunions take years to develop, it’s important to be aware of their presence and take note of any pain or other unpleasant symptoms that they cause you to experience so you can decide if bunion surgery is right for you.
Your big toe joint is responsible for bearing a significant portion of your body weight when you are standing and walking or running. Most commonly pain is experienced around the bunion when wearing shoes, which increases when doing any weightbearing activity.
Common symptoms include:
Pain may also be experienced under the balls of the toes (metatarsalgia) joint, and you may also experience secondary foot issues, including the formation of hammertoes, corns, and calluses.
A bunion can alter the biomechanics of your forefoot and affect the way that you walk or run. This can cause issues with other parts of your body such as your knees, hips and back.
Bunion surgery may be the only way to remove a bunion and completely correct the problem.
Though bunions aren’t considered a serious medical condition, as they grow that can become very troublesome, painful and unsightly.
Bunion surgery is indicated when conservative treatments such as custom orthotics, bunion shields, and anti-inflammatory medications have not been effective in alleviating your pain and the discomfort associated with the bunion.
It is important not to delay surgery for too long, as ignoring your symptoms will just lead to secondary complications, poor mobility and reduced quality of life. It also often means that a more invasive procedure will be required to correct the deformity.
Some patients with bunions have no symptoms at all, in which case there is no indication for surgery. Surgery should not be performed for cosmetic reasons alone.
The surgery that is required will depend on the severity of your condition. In most cases it is performed as a minimally invasive procedure which only a very small excision.
For mild cases, the surgery required is quite minimal. However, in general more severe deformities will require your bunion surgeon to perform a procedure to break the bone, realign it and reset it with 2 or 3 small screws to fix it into the desired position.
Sometimes severe deformities or patients with arthritis may require a fusion of the big toe joint. This provides excellent pain relief and stability of the joint.
Bunion Surgery is performed as a Day Case procedure, under a local anaesthetic ankle block. You can be awake, sedated or have a general anaesthetic during surgery, which takes about 45 minutes.
Most patients do not experience significant pain after surgery, although you will need to take some pain relief for a couple of weeks following your operation.
Post op you will be required to wear a stiff-soled shoe for up to six weeks post-surgery, and you will likely need to have some Physiotherapy rehabilitation to help you regain your strength and mobility.
Bunion surgery provides relief from pain by realigning the bones in your big toe joint. Once those bones are returned to their proper position and the bunion is removed, you should no longer experience pain or discomfort, and you can go back to all your normal activities.
Bunion surgery also works well to reduce sore and inflamed tissues that surround your big toe. Since inflammation is closely related to pain, a reduction in inflammation will also help to provide reduced pain
Following successful bunion surgery, your foot will function as normal, your movement and stiffness will improve, and you will be able to mobilise pain free.
When your foot posture and movement is back to functioning normally, you will put less strain/pressure on the big toe joint, and your lower limb biomechanics will improve. This leads to better movement and function of your other joints and will improve/prevent you from developing pain in other parts of your body.
Bunion surgery is considered a safe and effective procedure for alleviating pain and improving your overall foot function.
If you have any questions about bunions, your bunion surgery or your post op recovery, please get in touch with Mr Klinke - we are here to help you on every step of your journey and ensure that you have a smooth and stress free recovery.
Mr Martin Klinke is one of London’s most trusted, and experienced foot specialists. He performs many bunion surgeries each year, and is a highly skilled surgeon.
He offers this surgical treatment to private self-funded and insured patients at London Bridge Hospital, BUPA Cromwell, and New Victoria Hospital. He also runs outpatient clinics at Chiswick Outpatient & Diagnostic Centre, The Shard, Canary Wharf and One Welbeck.
You can find all his patient reviews here.
