No, it’s not a different type of onion or union.

A bunion a.k.a. hallux valgus refers to there being a large bump on the inner side of the foot, at the base of the big toe. These bunions can get injured or inflamed, leading to swelling and lots of pain.

Bunions seems to be more common in women and older adults; and over time, the bunion join becomes 

• larger
• stiffer
• more painful and tender

Some patients find it not just painful or have difficulties with finding a right size of shoe, but often many cant walk properly because of the pain and changes.

What’s a bunion?

Factors that may cause bunions:

• genetics (inherited genetically)
• foot shape
• flat foot / fallen arches
• osteoarthritis
• joint laxity / hypermobility in the joint at the base of the big toe

People often think that it’s “bad shoes” that causes bunions, but more and more studies are showing that footwear isn’t the main cause of bunions.

What does a bunion feel like? Signs and symptoms.

Unfortunately, this is one of those “it depends” kind-of answers, because some people can take more pain and some can take less PLUS some big bunions can be almost-pain-free and some tiny ones can be terribly painful, so it really varies.

What we can share is what our patients report:

• pain, tenderness and stiffness in that large big toe joint – worsens with use eg walking, standing, running
• impacts how one walks, even causes limping
• shoes are everything: it’s either NOT to wear any shoes that cause pains OR to find shoes that provide just nice support that there’s no pain at all
• the bump gets bigger and bigger with time
• bump can get inflamed and very painfully swollen

How physiotherapists can help

Physiotherapists can help with

• managing pain with standing, walking including going back to work, responsibilities and even exercise
• walking safely without causing more pain or aggravating the bunion
• footwear
• foot care
• education regarding proper footwear and self-care for symptom management

The key focal goals of physiotherapy

1. improve the angle of the big toe (prevent or delay worsening)
2. improve muscle strength and
3. reduce pain
4. improve walking

Physiotherapy bunion treatments may include:

1. Manual therapy may help improve the position of the big toe. It’s usually gentle forces to glide and move joints and soft tissue; in this case, we will gently move your big toe and ankle to reduce joint tightness and any stiffness of the surrounding tissues, and increase the big toe’s moving and bending range of motion.
2. Exercise such as range-of-motion, stretching, and strengthening exercises to improve the alignment of the big toe when standing, and improve your walking pattern.
3. Balance training specificly to bear in mind bunions and balance; to help reduce the risk of falling.
4. Symptom and pain relief management by teaching you how to use foot elevation, self massage, cold and hot therapy
5. Taping to improve the big toe’s alignment, and reduce pain.
6. Foot wear careful selection to better support and not aggravate bunions.
7. You may be recommend the use of splints, foot orthotics, or assistive devices, depending on your condition, and train how to use them. These may include:
   • splints and toe separators to reduce pain and pressure on the big toe.
   • custom arch supports (foot orthotics) to help keep the foot and ankle in a midline position during walking.
   • walking aids such as cane, walker, or crutches (assistive devices) to reduce pain and improve walking ability.

Physiotherapy after bunion surgery

For a minority of cases, the bunion is too painful to step or walk in, then surgery may be required. After bunion surgery, the physiotherapist in charge will help you to

• restore the strength of the big toe
• restore the flexibility of the big toe
• reduce pain
• improve your walking ability

Physiotherapy is different and varies with each patient, because it’s based on their condition and the type of surgical procedure performed, as well as how fit the patient is before the surgery. After the surgery, patients may be required to wear a special postoperative shoe to protect your foot, and avoid putting pressure on the surgical area for about 4 weeks.

A hospital physiotherapist will first teach you

• how to walk with a cane, walker, or crutches to avoid putting weight on the surgical area
• to help prevent injury on the post-op bone and wound to ensure that the bones heal well
• use cold therapy and leg elevation to control pain and swelling

Post bunion surgery physiotherapy with outpatient / community physiotherapy usually will begin 1-2 weeks after your bunion surgery, and continue for 6 to 12 weeks. Treatments will include the elements listed above.

The first session will focus on pain relief and swelling management with the use of mild ankle range-of-motion exercises, cold therapy, and gentle retrograde massage. You will begin gait training with specific instructions from us, and perform exercises in the clinic as well as at home too (the physio will assess, teach and advise you).

Postoperative physiotherapy will emphasize walking and learning how to push off of your big toe properly to restore normal walking ability. It will also include exercise to strengthen the big toe and ankle, and movement to restore better bending of the big toe.

It is important to regain strength and bending in the big toe to restore your full walking ability. You will be encouraged to perform a home-exercise program between physiotherapy treatment sessions as well as after the visits are completed, to help you return to your job, leisure, or sport activities.

Where To Next?

• Go to Home / Start
• Learn and find out more about your pains (bones, muscles, joints, tendons, ligaments, nerves etc) at Pain Conditions & Injuries
• Visit our shop to see products we recommend for pain relief, heating, treatments and more
• Contact us