When dealing with feet, it seems no other word conjures up gross images faster than “bunion”. In reality though, bunions are no more than a simple misalignment of one of the body’s most important joints. Yes, the side effects of having a bunion can yield some gross-looking conditions, but a bunion itself is a lot less cringe-worthy.
Bunions, or what we call “Hallux Abducto-valgus (HAV)” when we want to sound smart, can be described as a rotational dislocation of the big toe joint. It’s a pretty complex process, but simply think of it as the big toe leaning towards the second toe, making the big toe joint protrude from the side of the foot. This joint is a work-horse: when working properly it handles more than 3/4 of your body weight each time you take a step, so any change in its function or position can have a significant impact on the body.
Pain can result from the joint that now bends a little more awkwardly with each step, resulting in strain on the soft tissues surrounding the joint, and on the cartilage within the joint, eventually wearing down to cause arthritis. Pain can also be caused by the now-widened foot being squeezed into less-than-perfect footwear, causing the “gross stuff”: callus, corns, blisters, or in severe cases, ulceration and infections.
Causes of bunions are mainly mechanical. Foot function is by far the main culprit. Any imperfections in foot mechanics, which can be due to many reasons, can eventually lead to a bunion formation; excess force applied to the side of joint over time is what gradually forms the bunion. The more significant the underlying problem is, the faster the bunion can develop. Yes, footwear does play a role in a bunion development, but typically the underlying mechanical faults are still there. Not everyone who wears pointed- or narrow-toed shoes develops a bunion.
Surgery is not the best option, and Chiropodists typically only recommend this as a last resort. This is because surgery can improve the alignment of a joint cosmetically, but doesn’t deal with the underlying cause, so the problem can return. Surgery may also compromise the mobility of the joint, leading to other potentially worse problems down the road.
Treatment by a chiropodist involves symptom relief, such as dealing with corns, callus, or blisters, and then addressing the underlying mechanical problems to improve joint function and slow the progression of the condition. Evaluation of foot structure and function is vital in determining whether footwear, exercises, stretches, orthotics, referral to a physiotherapist, or any combination of these treatments is necessary.