Bunions and common foot problems explained

What a bunion is

A bunion is a bony bump that develops on the side of the foot at the base of the big toe. It forms when the joint there gradually changes shape, so that the big toe leans in towards the other toes while the joint itself pushes outwards, creating the characteristic bump. The medical name is hallux valgus, referring to the big toe drifting out of line. Over time the bump can become larger, and the skin over it may get red, sore or hardened from rubbing against shoes. The big toe may start to overlap or push against the second toe. Bunions usually develop slowly over years and tend to worsen gradually. They are very common, more so in women, and can run in families, as the underlying foot shape that makes them likely is often inherited.

What causes bunions and who gets them

Bunions are thought to result from a combination of the natural shape and mechanics of the foot and the pressures put on it. A tendency to develop bunions often runs in families, because the inherited structure of the foot — how the bones and joints are arranged and how flexible they are — influences whether the big toe joint drifts out of line. They are far more common in women, and tight, narrow or high-heeled shoes that squeeze the toes are widely believed to contribute or make them worse, though the foot shape underneath is usually the main driver. Conditions that affect the joints, such as inflammatory arthritis, can also lead to bunions. They become more common with age. While footwear plays a role, it is important to know that many people develop bunions largely because of an inherited foot type, not simply because of the shoes they wear.

How bunions are managed

Most bunions can be managed without surgery, and the aim of non-surgical care is to relieve pain and slow any worsening rather than to reverse the bump. Wearing wide, comfortable shoes with a deep, roomy toe box and a low heel takes pressure off the joint, and avoiding tight or pointed shoes helps a great deal. Soft bunion pads or shields protect the bump from rubbing, and cushioning or specially made insoles can improve comfort and support. Simple pain-relief measures and, if needed, advice from a podiatrist can help manage discomfort. Surgery is considered only when a bunion causes significant, persistent pain that interferes with daily life despite these measures, not simply for the appearance. An operation reshapes or realigns the joint, but recovery takes time and, as with any surgery, it carries risks, so it is weighed up carefully with a specialist.

Other common foot problems

Bunions often come alongside other foot problems. A bunionette is a similar bump on the outer side of the foot at the base of the little toe. Hammer, claw and mallet toes are toes that become bent at the joints, sometimes rubbing on shoes and forming corns. Corns and calluses are areas of thickened, hardened skin caused by pressure or rubbing, often over bony points or under the ball of the foot. Ingrown toenails, where the edge of a nail grows into the surrounding skin, can become painful and sometimes infected. Verrucas are warts on the sole caused by a virus. Athlete's foot is a common fungal infection causing itchy, flaky skin, especially between the toes. Flat feet and high arches can also contribute to aches. Many of these problems are linked to footwear, foot shape and pressure, and often improve with similar simple measures.

When to seek help and self-care

Much foot trouble can be eased with self-care: choosing well-fitting, supportive shoes with room for the toes, keeping the feet clean and dry, moisturising dry skin, cutting toenails straight across to prevent ingrowing, and using cushioning or pads to protect sore areas. A podiatrist can assess foot problems, treat corns, calluses and nail problems safely, provide insoles and advise on footwear. See your GP or a podiatrist if foot pain is persistent or interfering with daily life, if a bunion or bent toe is getting worse, if an ingrown toenail becomes red, swollen or leaks pus, or if a foot problem is not improving with self-care. People with diabetes or poor circulation should take particular care of their feet and seek prompt advice for any foot problem, however minor, because they are more prone to complications and slow healing.