The biggest sign is the change in appearance (protrusion) of the big toe joint. You may also experience:
 

• Toes overlapping one another

• Redness from shoes rubbing against the joint

• Swelling

• Pain at the big toe joint 

• Thickened skin around the big toe joint

• Restricted ability to move or bend the big toe joint

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Grading standards do exist for categorising the severity of a bunion. One such scale is the Manchester Scale for visually grading bunion severity. It has four stages:
 

• No deformity

• Mild deformity

• Moderate deformity

• Severe deformity

Bunions can begin to form when pressure and force is placed on the big toe joint in a way that encourages the bony alignment to begin to shift. This pressure may have numerous causes, and there has been debate as to whether these causes are responsible for the onset of the bunion or they simply promote their inevitable development.

Often bunions are associated with narrow or pointed shoes and can run in the family. These are more prevalent in women than men, and are thought to be linked with a lack of stability at the big toe joint. Other contributing factors include:
 

• Poorly fitting footwear

• Regularly wearing high heels

• Flat feet

• Increasing age

• History of injury to the big toe joint

• Arthritic conditions

While the changes to the joint are often difficult to reverse, many steps can be take to reduce the rate at which the bunion continues to worsen. This involves:

• Avoiding wearing ill-fitting and inappropriate footwear (pointed shoes, narrow shoes, high heels)

• Wearing orthotics (if supplied) that improve the function and stability of the big toe joint 

• Using ice to help reduce pain if swelling and redness occur (icing for no more than 15-20 minutes every 2 hours)

When you notice a bunion begin to develop and you want effective strategies to reduce the progression of your bunion, we recommend seeing your Podiatrist. If your existing bunion is causing you ongoing pain, we also recommend that you book an appointment. The earlier you begin treatment, the more likely you are to achieve better outcomes. Most importantly your Podiatrist will be able to answer questions that you have about your feet. Your Podiatrist may also:

• Prescribe a custom pair of orthotics to help address any biomechanical factors that may be contributing to the development or progression of your bunion

• Make recommendations on appropriate footwear for you

• Teach you how to strap correctly for your bunion

• Use mobilisation techniques if your bunion is at an early stage

• Help with any subsequent problems caused by your bunion, such as the development of corns or callus

If treatment is not working and you continue to have concerns surgical options are available (upon referral to an Orthopaedic specialist). Although surgery should generally be considered a last resort, if you would like to know more, your Podiatrist can answer your questions, and refer you to the appropriate surgeon if indicated.

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