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Our experts tackle a variety of topics in their own words
What is a bunion?
When the big toe points away towards the second toe, a large bony lump is produced. This is known as a bunion. The medical term is a hallux (big toe) valgus (pointing outwards). The bony prominence is due to the bones pointing in the wrong direction.
What causes a bunion?
The cause of a bunion is usually due to a number of factors. Bunions do tend to run in families, and therefore there is a strong hereditary component to them. They can also be part of other medical conditions such as arthritis of the big toe, rheumatoid arthritis, hypermobility (double jointed) and flat feet. Poor fitting footwear and high heels are often blamed for the cause of a bunion but this is not substantiated. Bunions are certainly more common in women than in men.
Will it get worse?
It can be difficult to tell whether your bunion will definitely get worse. There is certainly a higher chance of a bunion getting worse if there is a strong history of very bad bunions in the family. They also tend to progress with conditions such as rheumatoid arthritis.
Why are bunions painful?
Bunions tend to cause pain due to the bony prominence which can then rub on footwear. In some cases, it can cause pressure and irritation on the nerve on the side of the big toe. When bunions progress and get worse it can cause problems with the other toes, such as deformities of the neighbouring toes and increased pressure on the ball of the foot leading to pain (metatarsalgia) and stress fractures.
What are the treatment options?
Broadly speaking, bunions can be treated with or without surgery. The nonsurgical methods include wearing wide fitting shoes with soft materials to accommodate the bony prominence of the bunion. Toe straps and braces can help straighten the toe, but the deformity comes back as soon as the straps and braces are removed. Painkillers and avoiding activities that worsen the symptoms are often employed when there is acute pain at the bunion. The nonsurgical methods of treatment are aimed at managing the symptoms of a bunion, but none of them will permanently correct the deformity.
Surgery is only undertaken when the nonsurgical methods have been tried but do not resolve pain symptoms. Surgery involves straightening the bones which are pointing the wrong direction and holding them with screws and pins. This will allow the bones to heal in a corrected position. In some severe cases, further procedures may be done to correct the foot shape.
How successful is bunion surgery?
Over 90% of people are happy with the surgical correction of the bunion. However, the recovery time following surgery should not be underestimated. If you are thinking of having surgery for your bunion it is important to have a full medical consultation to discuss the treatment options and recovery time.
To book an appointment to see Mr Ieong, or one of our other highly experienced Orthopaedic surgeons, simply complete the contact form here or call 01442 331 900.
Consultant Orthopaedic Surgeon
Mr. Ieong is a consultant trauma and orthopaedic surgeon with specialist training in foot and ankle surgery.
Mr. Ieong qualified from Imperial College London medical school in 2007. He undertook his specialist orthopaedic training in London in the North West Thames London Deanery. He has had a broad exposure to foot and ankle pathologies and trauma. During his training, he has worked at St. Mary’s Major trauma centre and spent a year working with the foot and ankle department at the Royal National Orthopaedic Hospital where he gained experience in managing complex foot and ankle pathologies and reconstruction. He subsequently undertook a specialist foot and ankle fellowship at the Nuffield Orthopaedic Centre in Oxford, covering deformity corrections and arthritic conditions. This was followed by a foot and ankle fellowship at Addenbrookes Hospital in Cambridge, with further experience in complex foot and ankle trauma, and diabetic foot conditions. Mr. Ieong was appointed as a consultant orthopaedic surgeon to West Hertfordshire Hospitals NHS Trust in 2019.
Mr. Ieong maintains an active involvement in teaching surgical trainees. He is a member of the British Orthopaedic Foot and Ankle Society and keeps up to date by regularly attending conferences and educational courses. He has published his research in peer reviewed journals and has presented his work at a national and international level. He was awarded a place on the BOA leadership programme and has developed quality improvement projects in patient education and promoting a patient centred approach to management.
