Ask the expert: Bunions

BY Susannah Hickling

19th Sep 2023 Health

1 min read

Ask the expert: Bunions
Orthopaedic surgeon Dr Andrea Bianchi shares everything you need to know about bunions
How did you become a bunion specialist? 
When a Mexican surgeon solved the problem of hallux valgus—bunions—with small holes and no metal fixtures or screws, I learned and improved this technique. It was so successful I had almost no space left for anything else. 
Why do people get bunions? 
A congenital bunion is often a result of deformities from birth or inherited foot type. An acquired bunion is often a result of foot stress or injury or uncomfortable footwear—narrow sole, high heels or ill-fitting shoes. Arthritis, rheumatoid arthritis or osteoarthritis can also make you more prone to bunions. 
How can you prevent them? 
Opt for wider shoes and keep heel height to no more than four centimetres. It’s incredibly important to exercise the feet. With your feet flat on the floor, point your toes as far as you can and then curl them back underneath the foot as far as they will go. Take five seconds for each stretch and repeat ten times.
" It’s incredibly important to exercise the feet"
Then, while seated, roll a ball under the length of your foot for two or three minutes. If your foot isn’t properly aligned or you have fallen arches, you can wear over-the-counter shoe insoles, or custom-made shoe or heel inserts a doctor prescribes. 
When do bunions need treatment? 
Once bunions form, they won’t go away without surgery. They can cause chronic pain, swelling and redness over the big toe joint, particularly after wearing tight-fitting shoes or shoes that don’t fit properly.
"Once bunions form, they won’t go away without surgery"
Relieve discomfort with wide, low-heeled shoes with a soft sole, bunion pads and regular painkillers. 
What treatments are available? 
The most common type of bunion surgery involves cutting away the bunion and realigning the bones of the joint to make the sides of the food straighter. It uses screws and staple.
I favour—and practise—keyhole surgery which doesn’t use these and enables you to walk immediately after surgery. 
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