A bunion is a bony bump that occurs on the big toe joint. It may appear by itself or along with a deviation of the big toe towards the next toe. Because the bone sticks out, it may be red and sore itself. A hallux valgus is the deviation of the big toe, which may or may not be present with a bunion. The hallux valgus can lead to a bunion formation because it can stress the joint and create the bunion.
Causes of a bunion and hallux valgus includes genetics, pronation of the foot, shoe fit and other factors.
Just because others in the family have issues of this kind is not a guarantee that you will have them, but it will increase the chances of you having them. Extra care is needed to help you avoid these!
Pronation of the foot can cause a bunion because when the foot rolls, you can push off the inside of the big toe, leading to big toe joint strain and constantly forcing the angle of a hallux valgus.
Certain shoes can cause a bunion and hallux valgus by the kind of pressure your toe gets from a shoe. If the shoe points at the toes, or is tight at the toes, it can push the toes together, increasing the strain. Higher heels can also contribute because there is a narrow area for your toes and there is more pressure at your toes because of the high heel. This forces the toe to move towards the other toes.
Orthotics are a key portion of bunion treatments. Holding the arch at the correct height and stopping the foot from pronating too much will stop the progression of pronation related issues. In some cases, extra support or material can be added to relieve pressure under the big toe joint and help with pain relief.
Find shoes that fit you properly, especially at the front of your foot. Pick a shoe with:
- Enough room for the bunion to be comfortable and not irritated. Look for shoes that are wide enough for your feet. The opposite can be harmful as well. If the insole has too much space around the edge, the shoe may be too wide and the toes would have to clench to hold the shoe on. This can aggravate bunions. You may need to find a shoe that comes in multiple widths to fit your feet.
- Enough room for the toes at the front. A square toe box is a lot better than a pointed one. Take a look at the shape of your toes when barefoot.
- Avoid higher heels. Generally, 2.5″ heels is the highest you would want to wear. Switch out of those and wear lower heeled shoes for most of the time. A heel higher than that puts too much pressure on the ball of the food and will irritate the big toe joint.
Changing the laces on the shoe can improve the fit of the shoe around the bunion. There are lacing patters that can take pressure away from the bunion.
Some shoes will have something called a split width shoe. These are specifically made for people with narrower heels and wider at the forefoot. If will show on shoes like 9.5 D/EEE. That says the heel is a D width and the ball of the foot is an EEE width. When these shoes are not available, make sure that your foot sits comfortably on the insole and that your foot does not hang over the insole of the shoe. If it does, the shoe is too narrow.
Bunion splints are devices worn at night to pull the toe towards a straight alignment. By pulling the toes towards a more proper anatomical position, it can help to slow down the progression of the hallux valgus.
Pads can be worn around the bunion to prevent irritation from the shoes. Just be aware that if the shoe becomes too tight when wearing this, it might cause more irritation.
If you need help with support for your bunion, talk to your local Canadian Certified Pedorthist. You can find one at https://www.pedorthic.ca/.
Written by Jim Pattison, C. Ped (C)