Recognising the signs and symptoms of bunions

The most recognisable symptom of a bunion is the visible angular bump on the inward turned big toe.

Other signs and symptoms include:

• Inflamed skin which is red and swollen in the soft tissue portions of the foot as well as on the side of the big toe (warmth may also be felt around the bump)
• Occasional or persistent foot tenderness, pressure or pain (soreness at the joint or base of the big toe and in the ball of the foot)
• Difficulty in moving the big toe around (decreased flexibility)
• The development of thickened skin or corns along the underside of the big toe
• The development of calluses or corns, often on the second toe

The formation of a bunion can take several years to develop, and for some is initially more of an unsightly annoyance than painful. As the angular bump becomes increasingly pronounced, pain and inflammation develop, and can lead to complications over a period of time. A bump affected by inflammation eventually becomes warm to the touch and can sometimes be shiny in appearance.

Pain and pressure is at its worst when walking or wearing footwear. While barefoot or at rest, pain and pressure typically alleviate somewhat. A person may also experience discomfort in relation to the type of footwear that is worn. For instance, flimsy-soled shoes provide little support to the feet and can contribute to additional stress affecting a bunion joint, thereby increasing discomfort (instability), pressure or pain.

Some individuals may also experience burning sensations along with pain or numbness in the toes of the affected foot when a bunion is fairly pronounced.

Should a bunion be left alone?

In short, no (or not for too long at least). A bunion, even without painful symptoms does eventually require some medical attention.

The metatarsophalangeal (MTP) joint is what normally helps a person to distribute their body weight while performing a variety of mobile activities (like walking, running, dancing etc.). The abnormal formation (i.e. a bunion) that develops at this juncture of ligaments, bones and tendons thus has a huge impact on a person’s ability to function normally.

The formation of a bunion at the location in which it occurs is thus critical, and eventually begins to affect the other toes of the foot, further impairing normal function. With increased pressure on the big toes, a domino effect occurs and impacts the others. The other toes may develop calluses or corns, become bent (turn inwards) or even form hammertoes (bent at the middle joint). Toenails may also be affected and can become ingrown.

Naturally the discomfort prompts a person to shift their body weight in order to alleviate pressure, discomfort or pain, diverting their weight and altering the way in which they move slightly. A shift in weight means that pressure that is no longer on the big toe joint subsequently impacts the other metatarsals which do not normally accommodate it and are not really designed to do so. The result is a build-up of pressure and discomfort in the ball of the foot.

Once the foot is misshapen and a bunion forms, the issue does not resolve on its own. In fact, as a progressive condition, a bunion will ultimately result in more and more discomfort, further hindering a person’s capacity to wear normal shoes, and increasingly impacting the ability to walk. Like the condition itself, symptoms and their impact, progressively worsen over time. This ultimately encourages sedentary habits, which affect wellbeing, health and overall quality of life.

When to consult a doctor

Painful symptoms which develop, especially when walking in flat shoes (that should normally be comfortable to wear), should be evaluated by a medical professional. You may be referred to a podiatrist (a specialist in the study, medical diagnosis and surgical treatment of disorders relating to the feet, ankles and lower extremities) or an orthopaedic foot specialist (a surgeon specialising in conditions involving the musculoskeletal system) as these medical professionals specialise in diagnosing and identifying the cause of the problem (a bunion or other disorder) as well as treating it.

Persistent pain can indicate a variety of foot-related disorders, not just bunions. Bursitis, bone spurs (bony projections / osteophytes that develop along the edges of bone structures), or even gout / gouty arthritis, can also present similar painful symptoms.

Other than pain, signs and symptoms worth evaluating include the visible bunion bump, decreased flexibility (i.e. an increasing disability in moving or walking comfortably or without pain), and problems with finding footwear that fits and can be worn comfortably. If a bunion begins to impact a person’s quality of life, and displays uncomfortable symptoms, it is best to consult a medical professional.