Overview
What are Bunions?
A bunion is a foot deformity referring to the bony bump or prominence at the base of the big toe.
- It happens when your big toe is angled towards the second toe.
- The bunion may be painful or swollen.
- It may cause problems with footwear which rubs on the skin and soft tissue surrounding the bony bump. It may also cause subsequent toe deformities to the other toes due to lack of space within the footwear.
Causes
The exact cause of bunion is unknown. It is likely due to numerous factors:
- Abnormal foot structure which is hereditary
- Underlying inflammatory joint conditions
- Footwear or shoes with narrow or pointed toe box which compresses the toes and results in deviation of the big toe over time
- Foot injuries
What are the symptoms and problems that are caused by bunions?
- Intermittent or persistent pain, redness and/or swelling
- Rubbing of toes against one another or against side of footwear. This can form blisters especially in poorly fitted footwear.
- Formation of corns and callus
- Restricted movement of the big toe
- In severe cases, the big toe can push the lesser toes up or down out of place
- Difficult to find footwear that can accommodate the bunions
Prevention
Can Bunion be prevented?
- Avoid the use of high heel shoes
- Avoid shoes with poor support such as those without heel counter or flexible midsole.
- We recommend wearing shoes with low heel and wider toe box
- Consider calf stretching which may help to prevent shortening of the calf muscle
Detection & Treatment
What is the treatment for Bunion?
Conservative management may include:
- Footwear review and recommendation by a podiatrist
- In certain individuals, the podiatrist may recommend an insert (off the shelf or custom made) also known as an insole which may improve foot function and reduce pain
- Stretching exercises
- Pain relief medications
Consult your healthcare professional or podiatrist
If you have severe pain or trouble walking, your doctor can refer you to an orthopedic surgeon. There are many different types of surgery to realign the toe or remove the bony bump of a bunion.
Care Management
What can I do?
- Wear wide toebox, low heel shoes that have extra space around the big toe to accommodate bunion.
- You can perform toe exercises to strengthen and stretch your toes. However, these exercises do not correct the deformities.
- Buy proper fitting shoes preferably at the end of the day.
- Choose shoes with a wide and deep toe box and a low heel.
- Bring your footwear for asssessment by our podiatrists. Refer to our pamphlet on "Footwear" for more details.
- Take medicine to reduce pain
- Part of good diabetes care, you are encouraged to have your diabetes, cholesterol and blood pressure under control.
What are the types of stretching exercise?
1. Toe Stretches
- Stretch out your toes to keep them flexible and this may help to reduce foot pain.
- Point your toes straight ahead for 5 seconds and then curl them under for another 5 seconds. Repeat this set 10 times.
- This stretch can be useful if you also have hammer toes, or claw toes in addition to a bunion.
2. Toe flexing and contracting
- Press your toes against a hard surface or a wall and hold the position for 10 seconds. Repeat this action 3 to 4 times.
- Flex your toes in the opposite direction and hold the position for 10 seconds. Repeat this action 3 to 4 times.
3. Resistance exercises
- Wrap a towel or belt around your big toe and use it to pull your big toe towards you. At the same time, use your big toe to push forward against the towel.
4. Arch roll
- Sit down and place a golf ball on the floor under your foot. Roll it around under your foot for 2 minutes.
- This massage can help relieve foot strain and cramping.
5. Towel curls
- You can strengthen your toes by spreading out a small towel on the floor, curling your toes around it, and pulling it towards you. Repeat 5 times.
6. Picking up marbles
- Another gripping exercise you can perform to keep your foot flexible is picking up marbles with your toes. Do this by placing 20 marbles on the floor in front of you and use your foot to pick the marbles up one by one and place them in a bowl.
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