Bunions – Treatment & Management

Everyone knows at least one friend or relation is that is affected by bunions. A bunion is a painful condition that forms in the joint at the base of the big toe and can be extremely painful when pressure is applied to that area. It occurs in when the metatarsal bone of the big toe angles outwards and the big toe itself angles inwards pushing against the second (known as Hallux Valgus Deformity, see Illustration). After several years, deposits of bone growth build up on the outside of this protruding deformed joint, causing the surrounding muscle tissue to become swollen and inflamed leading to the formation of an abnormal painful bursa, which is commonly known as a Bunion (see illustration )

The Hallux Valgus deformity are predominately hereditary, but there occurance is greatly enhanced by wearing of shoes with narrow toe boxes, such as high heels. Such narrow fitting shoes force the big toe to be pushed inwards towards the 2nd toe leading to the eventual outward angling of the joint at the base of the big toe.

Hallux Valgus Deformity leads to Bunion formation

Bunion occurs after Hallux Valgus Deformity

Treatment & Management

Even though in many cases the angling inwards of the Big Toe cannot be altered to its original position by conservative treatment, it still needs to managed to prevent its angle worsening leading to bunions, poor foot control when walking which can result in knee and ankle problems overtime. The Hallux Valgus of the Big Toe can be managed by physio Taping techniques which achieve some success over a 6-8 week period. Manual release of tight flexor tendons that attach underneath the 1st metatarsal bone and Big Toe.

What can you do?

A poor fitting shoe accelerates the angling inwards of the Big Toe and the formation of bunions, hence we need to do the following;

  • Avoid wearing high heels with a very narrow heel base

  • If wearing a high heel, pick a shoe with a gradual incline

  • Don’t wear a high heel where there is a big gap behind the heel

  • Wear a silicone metatarsal pad underneath the ball of the foot with high heels.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.

Contact Number: 086 3275 753

Email your queries to: info@tipp-phyiscaltherapy.ie

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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Insurers : You can receive rebates on your Physical Therapy visits.Tax relief is available on all Physical Therapy costs, Tax relief may be claimed by filling in the MED 1 form available from www.revenue.ie.

Receipts are provided after each treatment for tax or health insurance companies.