What is a bunion?

  • A bunion is a biomechanical imbalance involving the great toe joint. It is often described as a bump on the side of the big toe. Several different things may cause bunions, such as:
  • Congenital deformities present at birth
  • Genetic Inheritance such as Ligamentous laxity (looseness of ligaments) 
  • Mechanical factors such as activity and/or tight fitting shoes that can lead to arthritis
Bunions progressively worsen over time. Bunions start when the big toe rotates sideways towards the second toe and the first metatarsal projects outward in the opposite direction producing the characteristic bump, which increases prominently over time. 
 Characteristics of a bunion also include:
  • Bump on the inside of the foot
  • Great toe pushing onto the second toe
  • Pain and swelling around the great toe
  • Difficulty walking
  • Calloused skin 

What causes a bunion?

Bunions can occur for several reasons, and it is important to remember there isn’t one specific cause. In general, bunions are a result of:
  • Genetics and a family history of bunions
  • Arthritis (inflammation) in the foot
  • Gout
  • Certain neuromuscular conditions that affect movement and coordination like cerebral palsy
  • Connective tissue disorders
  • Ill-fitting shoes

Signs and symptoms of bunions

If you are experiencing any of the following symptoms, consider making an appointment at ChilternWellbeing today to be seen by one of our bunion specialists:
  • Pain and swelling around the big toe
  • Calloused skin and swelling near the base of the big toe
  • The big toe is pushing the second toe out of place because it is turning inward
  • The base of the big toe includes a large bump
  • Soreness near a big bump
  • Any difficulty or discomfort while walking


Once the nature and severity of the bunion is thoroughly assessed the best treatment options will be reviewed in great detail with the patient.
Bunion treatment options
At Chiltern Wellbeing, we pride ourselves on performing conservative treatment first before the need for onward referral for surgical intervention.
Nonsurgical treatment options include:
  • Shoe gear modification: Using wider shoes with larger toe boxes
  • Splinting, strapping, cushioning, and padding of the bunion
  • Custom orthotics to stabilise and slow progression of the deformity
  • Avoidance of activities that aggravate symptoms
  • Anti-inflammatory medication for periodic relief
  • Physical therapy to calm the inflammatory process

Bunion surgery

The primary goal of bunion surgery is to relieve the pain associated with the deformity. Bunion surgery consists of removing the pronounced bone, realigning the big toe, and balancing the foot so the bunion does not return. This can be done by a Consultant Podiatric Surgeon or Consultant Orthopaedic Surgeon.
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