What causes bunions?
“No one single cause has been proven,” explains Trevor. “There are a number of
causes, and though shoes can exacerbate the problem, bunions do occur in
societies that don’t wear them.”
Michael Ratcliffe, a registered podiatrist who specialises in podiatric clinical
biomechanics, explains that we walk on the same type of ground all the time,
whereas the human foot was actually designed to adapt to varying terrains. In a
sense, a bunion is a type of repetitive strain injury. And like repetitive
strain injury, some people are more prone to it than others. One theory - though
it remains unproven - is that bunions are caused by one or both of the
1) Because the foot wasn’t designed to constantly walk on a level surface, the
ball of the big toe is slightly lower than the ball of the rest of your foot.
When your foot meets the ground, the ball of the big toe is pushed up, and the
big toe joint can’t bend as well as it was designed to. In order for the big toe
joint to bend fully as you walk, your foot rolls slightly over to the side (this
is also why people with hallux valgus often get hard skin).
2) Also, if your midtarsal joint tends to move from side to side more than it
does up and down, the arch in your foot collapses as your foot rolls in. This
also makes you more prone to developing bunions.
Such problems can be exacerbated by tight footwear. “Slip-on shoes can make
matters worse,” says Trevor. “Because they have to be tighter to stay on your
feet, you automatically have less room for your toes. And with nothing to hold
your foot in place, your toes often slide to the end where they’re exposed to
lots of pressure. Likewise, high heels throw more weight onto the ball of the
foot, putting your toes under further pressure.” If you haven’t got a bunion by
adulthood and you later develop one, there could be some underlying arthritis.
Arthritis is a disease of the joints which causes them to become
inflamed and stiffen. There are three types of arthritis - Rheumatoid, Osteo-
arthritis and Gout.
Gout is the result of an imbalance of uric acid in the body, and affects more
men than women.
The main symptom is waking up in the middle of the night with an acute throbbing
pain in the big toe, which is swollen. Usually only one of the big toes is
affected. The pain lasts for around three or four hours and will then subside
and usually not return for a few months. It can be controlled by drugs, which
your GP will be able to prescribe. The application of ice or cooling lotions
will help during an acute phase.
All three forms of arthritis can benefit from chiropody care. Registered
chiropodists (also known as podiatrists) work in the NHS and in private
practice. They will be able to adapt your existing footwear with orthoses or
other appliances, which fit easily into your shoes and help redistribute
pressure away from the affected parts.
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