Bunions: All you need to know about diagnosis and treatment

Written by: Mr Paul Hamilton
Edited by: Sophie Kennedy

Bunions can occur for all sorts of reasons and although they vary in their severity, they often lead to pain, swelling and discomfort when wearing shoes. We invited highly respected consultant orthopaedic surgeon Mr Paul Hamilton to shed light on how bunions are diagnosed and treated, including the lifestyle adaptations that can most significantly help to improve pain symptoms.



What is a bunion?


A bunion is a deformity of the big toe causing the toe to push or rub against the second toe and the development of a bony prominence on the inside of the foot.


What causes bunions?


Bunions can be caused by several factors. They can run in families, be associated with ligament laxity or be caused by other medical conditions such as rheumatoid arthritis. They may also relate to tight or ill-fitting shoes worn over long period and are more common in women.


What are the symptoms of a bunion?


The most common symptom of a bunion is pain, swelling, redness at the base of the big toe caused by the usual bony prominence. Symptoms are often aggravated by rubbing on tight fitting shoes.


As the condition progresses the toe may rub on the second toe and occasionally be associated with pain in the ball of the foot and clawing of the second toe. If the pain is within the big toe joint this may be as a result of arthritis developing within the toe joint. This may also be associated with difficulty moving the big toe.


Corns or calluses are common around the affected area and relate to rubbing on the shoes or between the toes. In severe cases, the big toe can overlap the second toe.


How is a bunion diagnosed and treated?


Diagnosis can be made after discussion and examination by an orthopaedic foot and ankle consultant. This is usually confirmed by weightbearing x-rays, although a weightbearing CT scan may also be used.


Treatment depends on symptoms and severity of the bunion. Properly fitting shoes, splints or over the counter simple pain killers or ice packs may alleviate the pain. In more severe cases or the symptoms affect daily living then surgery may be necessary. Surgery involves realigning the metatarsal and can may be recommended depending on the individual’s symptoms and expectations.


Can bunions be prevented?


There is often no way to prevent the development of a bunion, but there are some steps which can help alleviate the symptoms and prevent progression of the condition.

  • Wear shoes that fit properly such as those with a wide toe box.
  • Use insoles or orthotics such as an arch support especially in the presence of flat feet.


Others factors that may help include maintaining a healthy weight, stretching and strengthening the muscles in the feet to improve flexibility and avoiding high-impact activities.




If you are suffering with bunions and wish to schedule a consultation with Mr Hamilton, you can do so by visiting his Top Doctors profile.

By Mr Paul Hamilton
Orthopaedic surgery

Mr Paul Hamilton is a top orthopaedic consultant based in Surrey and London. He specialises in adult foot and ankle surgery and trauma surgery, including forefoot reconstruction, arthroscopy and arthroplasty, and is an expert in treating sport injuries, Morton's neuroma, arthritis and bunions.

After qualifying from St Bartholomew's and the Royal London Medical School, he completed three medical fellowships in the UK and a travelling fellowship to Boston, USA, giving him extensive specialist training. In addition to his private and NHS practices, Mr Hamilton is actively involved in research, and has published and presented his work in orthopaedics around the world.

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