This is a question we get asked a lot. Are they caused by pointed shoes? What can I do about them?

Well, the question about bunions is a big one, because the public tends to understand different things by the word itself.  Some people use the word to describe a bump on top of their big toe joint, others to describe the big toe drifting inward into a pointed shoe shape. Some people use it to describe a bump near their little toe.

The first condition I will talk about is what Podiatrists and Doctors call Hallux Valgus or Hallux Abducto Valgus.  This the condition where the big toe gradually drifts towards the mid-line of the foot causing a foot shape that looks like a pointed shoe.  This is an inherited acquired deformity. That means that you are not born with it but are born with a tendency to get it. Your genes mean that you will probably get it gradually as you get older. As the bunion gets worse, the next toe can also become deformed into a hammer toe. Some people get them worse than others and it can look like poor footwear cause it, but that isn’t really a factor in most cases.  Sometimes they can look very bad and not hurt much at all and for other people the deformity can be minimal and the pain quite bad.  Shoe fitting can cause a problem too.

Then there is the condition where you get an enlarged big toe joint or a bump on top of it, but the big toe is still straight. We call this Hallux Limitus or Hallux Rigidus. This is caused by arthritis in the big toe joint. Most people develop a little wear and tear in this joint as the years go on, but if there is a lot then the foot can not move freely and there can be pain.

And last, when the bump is on the outside of your foot near your little toe, and the little toe is drifting inwards towards the middle of the foot. This is what we call a tailor’s bunion.  This isn’t caused by poor footwear either. It is more common in people who have hypermobile feet (double jointed).

Treatment for all these conditions depends on the symptoms and why those symptoms arise. 

If shoe-fitting is a problem, then a Podiatrist can give advice, tips and suppliers or appropriate footwear. Sometimes this is all that is necessary.

If there is pain within the big or little toe joint but there is good movement, then this is a situation where an orthotic (arch support) can be useful. It is important not to just purchase from the internet as all arch supports are not equal. A Podiatrist who specialises in Biomechanics or MSk will be able to look at how the foot is moving and aim to improve that.  Sometimes joint mobilisation or a steroid injection can help with joint pain too.

If the joint is restricted or the deformity is too bad for normal shoes, then often the only way to get an improvement is surgery. However, it is best to look at all the non-surgical options before opting for surgery. A Podiatrist will be able to guide you as to when surgery is the best option.


The Foot Room Longridge and Broughton offer outstanding Chiropody and Podiatry for the areas of Fulwood, Preston, Garstang and Whalley. We specialise in treatments for ingrowing toenails, fungal nails, verruca, corns and dry cracked heels. We do gait analysis and biomechanical assessments for sports injuries and orthotics as well as spa pedicures, warm wax treatments and nail painting.

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