Can Bunions Be Prevented?
As many as one in three females may suffer with bunion deformities of either one or both feet. All authorities agree that bunions tend to worsen over time. What is not clear is by how much and over what period of time. Some may settle and can be managed without surgery. Firstly ensure you are wearing the correct sized footwear. Select a shoe that conforms as nearly as possible to the shape of your foot, which ensure that your toes are not compressed. Also have your feet measured as most people have one foot longer than the other.
The best way to reduce your chances of bunion progression is to wear shoes that fit properly. However, around 80% of bunions are hereditary; which makes it more likely that they will progress regardless of footwear precautions.
Bunion deformities are more common in females than males and therefore it is likely that tight shoes such as fashionable high heels can force your toes together and worsen the bunion deformity. Pointy shoes – where toes are squeezed into a cramped space – can cause bunions not only on the big toe joint, but also on the small toe – also known as Tailor’s bunion or bunionette. Bunions are also present, but less common, in unshod populations.
Some authorities recommend exercising the feet to strengthen them. For example learning to pick up small objects, like a pencil or pebble, with your toes. However, there is little researched evidence to support this approach.
In our practice we have seen adverts for devices that are purported to help correct bunions, such as toe splint etc. Research has shown that these are unhelpful in the adult foot but have some limited value in the growing foot where a bunion is called juvenile hallux valgus. In this case a child’s night splint may help to slow down the progression of the bunion deformity. We do perform corrective surgery for paediatric cases, however, the bones of the feet need to have stopped growing; around 14-16 for girls, and 16-18 for boys.
A number of patients who have bunions have a condition called overpronation. This means that when you're standing or walking, your feet have a tendency to roll inward toward the big toe joint. Over time, the toe joint can deform, encouraging a bunion. Although there is scant research in this area, many patients can benefit from anti-pronatory shoe inserts (orthotics) to help relieve the pressure and stress on the big toe joint as you walk. You can talk to your specialist podiatrist about these.
When the bunion is irritated and painful, warm soaks, ice packs, and nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help. Whirlpool, ultrasound, and massage may also provide some relief. Also when bunions become inflamed and acutely painful, a pain-killing anti-inflammatory injection into the inflamed bunion joint can be very helpful. Initially we use a cortisone injection. Up to four injections can be given. We also use a joint fluid replacement injection which replaces the loss of normal cushioning and shock-absorbing synovial joint fluid which can occur when joints are inflamed (Durolane).
Although all surgical procedures carry associated risks, research however shows that surgery is the only bunion treatment that will reverse the deformity and is therefore the most successful option for treating bunions. If conservative action has not helped and you are still suffering with pain and discomfort a consultation with a specialist podiatrist is advisable. Examination and x-rays will tell us the severity of the deformity and will inform one which type of surgical treatment is best for you.
The picture below shows an example of one of our patients with a moderate bunion deformity; taken in theatre immediately following successful correction by osteotomy.
The picture below is a correction of a milder deformity which can achieved with a much smaller incision on the side of the joint using our new ReLine plate from the USA. This allows for a much quicker recovery, less swelling and a protective walker boot is not necessary. Many patients can return to work in a trainer or roomy footwear such as Ugg boots, after as little as two weeks with type of surgery as the correction is much stronger than standard techniques.