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Bunions Treatment in Singapore
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What are Bunions?
Bunions, also known as hallux valgus, are a common foot condition characterised by a noticeable bony bump at the base of the big toe. This condition develops over time due to alterations in the structure of the bones at the front part of the foot. These changes cause the big toe to move towards the second toe, which results in the protrusion of the joint at the base of the big toe. This forms the bunion bump.
The formation of a bunion is a progressive process, during which the normal structure of the bone is altered. As this deformity increases, it can cause discomfort and pain, making it challenging to wear shoes or walk. Bunions can vary in size, and in some cases, smaller bunions, referred to as bunionettes, may develop on the joint of the little toe.
Causes of Bunions
Bunions are caused by a mix of genetic, environmental, and biomechanical factors.
- Genetic Predisposition
People with a family history of bunions are more likely to develop them. This genetic link often involves inherited foot types that are prone to bunions due to their structure and mechanics. - Poorly Fitting Footwear
The type of shoes worn influences the development and aggravation of bunions. Footwear that is narrow, tight, or has high heels can force toes into an unnatural position, contributing to the formation of bunions. - Foot Stress and Injuries
Excessive stress on the foot, whether through certain activities or injuries, can contribute to the development of bunions. This includes occupations or sports that exert excessive pressure on the feet, as well as foot injuries that alter the foot’s alignment or structure. - Certain Types of Arthritis
Certain types of arthritis, especially inflammatory ones like rheumatoid arthritis, can predispose individuals to develop bunions. Inflammation can affect the joints and the surrounding structures in the foot, leading to bunions. - Congenital Deformities
In certain instances, bunions may be linked to congenital deformities. These conditions can set the stage for the development of bunions later in life.
Symptoms and Signs
Bunions present a range of symptoms and signs, which typically develop progressively.
- Visible Bony Bump: The most distinctive sign of a bunion is the visible bump on the outside of the base of the big toe. This appears as the bone structure of the foot gets altered.
- Pain: Pain can range from mild to severe. It may be constant or intermittent and often worsens with the pressure of tight shoes or prolonged standing and walking.
- Inflammation and Redness: The area around the bunion can become inflamed, leading to redness and swelling. This can exacerbate discomfort and pain, especially when pressure is applied to the joint.
- Corns and Calluses: Corns and calluses may develop as a result of toe misalignment. These are areas of thickened skin caused by the friction and pressure of the toes rubbing against each other or the inside of the shoe.
- Restricted Movement: In some cases, the movement of the big toe may become limited. This can affect walking and other foot movements.
Diagnosis
The diagnosis of bunions involves a combination of medical history review, physical examination, and diagnostic imaging.
- Medical History: Initially, the foot specialist will inquire about the patient’s foot pain, previous foot problems, and any family history of bunions or other foot-related conditions.
- Physical Examination: During the physical examination, the foot specialist will inspect the foot, focusing on the bunion area. They will look for signs of redness, swelling, and tenderness. The range of motion of the big toe and the condition of the skin around the bunion can also be assessed.
- X-ray Imaging: X-rays are commonly used to view the bone structure of the foot and evaluate the extent of the deformity.
Non-Surgical Treatment Options
Bunions can initially be managed by non-surgical treatments, which aim to alleviate pain and prevent further progression of the condition.
Footwear Modifications |
In less severe cases, the foot specialist may suggest modifying footwear to provide pain relief. Shoes should be comfortable, with a wide toe box to accommodate the bunion and prevent crowding of the toes. Custom or over-the-counter orthotic devices can also be beneficial, to help redistribute pressure and align the foot properly. |
Padding and Cushions |
Over-the-counter bunion pads or cushions can provide a buffer between the foot and the shoe, reducing pain and discomfort. These pads help in distributing pressure more evenly across the foot. |
Medications for Pain Relief |
Pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be used to manage pain and inflammation associated with bunions. In some cases, cortisone injections may also be considered. |
Physical Therapy |
Engaging in physical therapy can help maintain joint flexibility and strengthen the muscles around the foot and big toe. Exercise and stretches can be beneficial in managing symptoms and improving foot function. |
Surgical Treatment Options
When non-surgical treatments do not provide sufficient relief, surgical intervention may be considered to correct the bunion and alleviate pain. The choice of surgery depends on the severity and nature of the bunion.
Tissue Removal
This surgery involves removing the swollen tissue from around the big toe joint. It can be used to alleviate the pressure and discomfort caused by the bunion.
Bone Realignment
This is a common surgical approach used to realign the bones in the foot. It may involve removing a portion of the bone to straighten the big toe and correcting the abnormal angle in the big toe joint.
Joint Fusion
For more severe bunions, joint fusion might be necessary. This procedure involves removing damaged cartilage and bone, and then fusing the bones of the joint. While this can eliminate the source of pain, it can result in permanent immobility of the joint.
Prevention Strategies
Preventing the development or worsening of bunions involves several practical measures focused on foot health and care.
- Using Proper Footwear - Select shoes that fit well and provide adequate room for the toes. Shoes with a wide toe box, low heels, and sufficient space at the end for the longest toe can help prevent the formation of bunions.
- Avoiding High Heels and Narrow Shoes - High heels and shoes with narrow, pointy toes can exacerbate bunions by forcing toes into an unnatural position. Limiting the use of such footwear can reduce the risk of developing or worsening bunions.
- Using Orthotic Devices - Using orthotic devices, either custom-made or over-the-counter, can provide support and correct foot alignment. These devices can be particularly beneficial for individuals with foot structures that predispose them to bunions.
- Maintaining Healthy Weight - Higher body weight can put additional pressure on the feet, potentially contributing to bunion formation. Maintaining a healthy weight can help reduce this risk.
- Foot Strengthening Exercises - Performing exercises that target foot strength can enhance overall foot health.
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew (傅圣耀) is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Shield Plans
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What Exercises or Stretches Can Help Treat Bunions?
Exercises and stretches that strengthen the muscles of the feet and toes can be beneficial for individuals with bunions. These exercises include toe curls, towel scrunches, and picking up objects with the toes. Stretching exercises that enhance toe flexibility can also help in alleviating discomfort. For tailored exercise plans and guidance, consult with your foot specialist.
Can Walking Barefoot Help a Bunion?
Walking barefoot, particularly on natural, soft surfaces, allows the feet to move naturally without the constraints of shoes. It can help in strengthening the foot muscles and improving balance. This should be approached with caution and at the discretion of your foot specialist.
What Happens If a Bunion Is Left Untreated?
If a bunion is left untreated, it may lead to further foot deformities and complications such as bursitis, hammertoe, or metatarsalgia. These complications can result in increased pain and mobility issues. Early consultation with a foot specialist can help manage the condition effectively and prevent further progression.
How Do I Know If I Have a Bunion or Gout?
Bunions and gout can present with similar symptoms, such as pain and swelling in the big toe. A bunion is a structural deformity, while gout is caused by the buildup of uric acid crystals in the joint. Consult your foot specialist for a definitive diagnosis of your specific condition.
How Long Does It Take to Treat a Bunion?
The treatment duration for a bunion varies depending on the severity of the condition and the chosen treatment approach. Non-surgical treatments can provide immediate relief but may require ongoing management. Surgical treatments may offer a more permanent solution, but recovery can take weeks to months.