What are bunions? A bunion is a curve that occurs at the big toe, affecting women and men in a 3:1 ratio respectively.
Fortunately, those who encounter bunions can seek treatment!
Hallux valgus (bunion) with secondary changes in the other toes
How and why do bunions develop?
The big toe is one of the most valuable assets that we have. It allows us to propel ourselves forward when we walk and push off when we jump or sprint. It stabilises the foot and prevents it from toppling over. Without it, bipedalism (walking upright on 2 feet) would not be possible or not nearly as graceful as it is today. When the big toe joint starts to develop a curvature, it is referred to as hallux valgus and commonly known as a bunion. Once this occurs the foot starts to malfunction and a set of cascading events slowly unravel. Bunion treatment can help to improve the severity of this condition.
The severity of a bunion (hallux valgus) is based on the angle illustrated in this x-ray. This is classified as severe.
Over hundreds of years, the big toe has changed its function, becoming more lever-like allowing us to walk far more effectively. This can be said due to the anatomy of our feet noted today. There are a few muscles that insert into the big toe at an oblique angle. Each one of them exerts a force onto the big toe, pulling into a bunion position purely because of the angle at which it inserts into the toe. All it needs is some encouragement. That encouragement comes in the form of foot joints that are too flexible allowing the muscles to overpower the big toe joint and pull the toe skew. This is the case for someone who has flat feet or has hyper-mobile joints. The bunion then starts to form making the foot unstable. The foot then compensates by calling on the second toe to start carrying the burden of propelling the body forward. Unfortunately, the second toe is made up of very slim bones and is not designed to carry such loads. Corn or hard skin soon develops underneath the second toe in response to this excess load. This weight shift from the first to the second toe is a common cause of pain in someone with a bunion, eventually requiring treatment. It is also the reason why the second toe eventually overrides the first toe after the excess load permanently damages the joint.
Illustrating how muscles of the foot function around the big toe joint can demonstrate how the foot is predisposed to bunion formation.
Bunions can also run in the family. On clinical observation, however, it appears as though we do not inherit the bunion itself but rather the factors the predispose us to develop bunions. Typical examples are inheriting a flat foot or a hyper-mobile big toe joint. Over a few years of walking (from age 1-9), we can then slowly start to develop a bunion because of the predisposing inherited anatomical factors being present. This is the encouragement mentioned above that then allows the muscles to slowly cause the bunion development.
Bunion treatment options
Bunion treatment can be challenging. Specialising in pain relief, our bunion treatments are either conservative and surgical. Conservative bunion treatment can reduce the pain and lower the angle by a few degrees, but it cannot straighten the toe completely.
Effective bunion treatment needs to address your overall foot function by restoring the big toe as the main weight-bearer that propels the foot forward. Then, painful secondary changes from occurring to neighbouring toe joints can be prevented. Conservative bunion treatment essentially keeps you pain-free and prevents deterioration. Conservative bunion treatment does, however, require the patient to be disciplined in shoe choices and treatment techniques.
In some cases where conservative bunion treatment fails or when the foot deformity hinders day to day functions, surgical bunion treatment needs to be explored. There are several procedures that realign the bone and joint, releasing some of the muscle’s pulling action. Depending on the type of bunion treatment, recovery times vary.
Once the curve of the bunion occurs, long term care is required by the individual irrespective of the type of treatment chosen.
We also offer treatments in other areas such as ingrown toenails, cracked heels and corns on the feet.
Meet a podiatrist today
Speak to our podiatrists in Malaysia at +603 7710 5244 and book an appointment. You may also contact our Singapore clinic at +65 6464 8654.
