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Ask Dr Trisha: Bunions

HealthBauer XcelPain
Ask Dr Trisha: Bunions

Victoria Beckham, Uma Thurman, Nigella Lawson – even the most glamorous stars can’t escape the misery of bunions. These bony deformities of the feet can affect anyone, although they do tend to run in families, so if your mother or father had them then it’s more likely that you will develop them too.

A bunion is a swelling at the base of the big toe, which usually sticks out towards the other foot. The formal medical term is Hallux valgus. Some people get similar problems on the other side of the foot, which stick out to the side at the base of the little toe – these are known as bunionettes. 

Under the surface of each foot, 26 bones, 33 joints and more than 100 tendons form a very complex structure which gives the foot both flexibility and strength to carry your body along.

A bunion develops when the pressure on your feet from your body’s weight pulls unevenly on the tendons and joints. This makes the joint at the base of your big toe unstable and the toe is pulled towards the other toes. As it does so, the end of the joint becomes distorted and with time forms a large knobble that juts out. Wearing narrow high-heeled shoes that cause abnormal pressures within your foot, injuries of the feet, your genes, or joint disease such as rheumatoid arthritis, can all increase your bunion risk. 

Bunions can be a constant source of misery. The swelling can rub on shoes causing corns and blisters. Changes in the mechanics of your foot may cause inflammation of little fluid-filled pads that cushion the joints of your feet (this is called bursitis) as well as painful inflammation under the ball of your foot. 

Your second toe may become distorted too, bending at the middle joint (this is called a hammer toe) and occasionally the big toe gradually moves right underneath the other toes, severely restricting the flexibility of the foot.

You can limit the severity of your bunions and reduce pain by wearing flat, comfortable shoes with plenty of space for your toes, and by using padding to reduce pulling or rubbing on the bunion. Splints may help to straighten your foot, while orthotics (specially-fitted shoe inserts or supports) can relieve pressure on the bunion.

For many people, an operation holds the best chance of relieving the misery. Surgery cannot restore the foot to normal, and is likely to leave it stiff, but may stop or reduce the pain, and reduce the size of the deformity. Your doctor can refer you to an orthopaedic surgeon if they think an operation may help.

Q. I’m prone to stomach bugs and find it hard to get back on my feet afterwards. How can I get over them faster?

Dr Trisha says: Prevent developing stomach bugs in the first place with scrupulous hygiene and top up your friendly gut bacteria with a probiotic supplement, available in supermarkets or pharmacies. Once you have a stomach bug, you need to get your body back into balance as soon as possible.

Drink plenty of fluids while you are unwell and try to keep eating too if you can, it keeps your energy up and will help you recover faster. Medicines that counteract diarrhoea, such as loperamide, can be very quickly effective and help reduce fluid loss, so take them as soon as diarrhoea starts.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing