Bunions – What are they and do I really need surgery?!

Bunions are something that we see regularly in our practice. People who have bunions are often worried because they can hurt, lead to other problems and can also be a cause for concern regarding other people’s reactions when wearing thongs and open shoes. You’ll have some peace of mind knowing that a podiatrist will never judge you for your bunions and will always look for the opportunity to help with both the bunion and movement and lifestyle also.

What are bunions?
A bunion is a lump at the side of the big toe joint (see photo) and a change in position of the two bones (the metatarsal and the phalange) that make up the joint. The lump, bony deposit, is actually an adaptation from increased stress at the joint.

When bunions start to form, the adaptation is less noticeable. Over time bunions can develop further where in some cases the lump that forms and the drift of the toe can impact comfort and the ability to wear shoes. 

What causes bunions?
Every single case of bunion formation is multi-factorial. That is, there is no absolute one cause of the problem.

With this in mind, and following lots of medical scientific research, there have been 4 main causes of bunions identified:

– Genetics.
– Biomechanical factors (walking with rolled in feet, or pressure at the side of the toe when walking)
– Ongoing use of tight fitting shoes
– Arthritic conditions

A podiatrist can help you identify what causes are most relevant to you and what you can do about it.

What are the symptoms of bunions?
People with bunions will often complain as the condition progresses.

People who experience early stage bunion formation may notice a change in joint appearance alone.

As the condition develops, people may experience pain and pressure as the toes rub on each other and the and side of the bunion rubs on footwear. The joint itself can also become stiff as the bony change around the joint occurs and this can lead to calluses and corns (skin lesions) forming and trouble with movement and activity. For someone who experiences trouble with movement, it is possible for other conditions to arise in knees, hips and backs. For this reason, people who’s bunions are progressing on from early stages can also report aches and pains in other areas of their body.

How are bunions diagnosed?
If you think you might have a bunion – you are probably right! Identifying if you have a bunion is rather easy as changes in the joint and position of the toes is rather noticeable.

What is useful to have diagnosed is the stage of the bunion formation. Is it an early stage bunion or is it more advanced? This is something that can help make decisions that will help you the most into your future.

What are the treatment options for bunions?
Conservative (without surgery) and successful treatment of bunions must take into consideration the most influential factors that caused the bunion in the first place.

For this reason a podiatrist will always take a thorough assessment, which will often involve many physical tests before offering any recommendation or advice.

Long term management of bunions can be managed well with:
– Orthotic therapy (see link below to learn more) 

– Strength and conditioning exercises of the foot and lower limb
– Ongoing management of associated skin pathology (corns and calluses)

Short term management options can include:
– Taping
– Bracing
– Splints
– Toe separators

Our clinic mission is to ‘empower lives’ and for this reason, our Podiatrists tend to recommend long term management options to help you achieve the best long term outcome and prevent the need for frequent appointments that focus only on short term management.

In some cases surgery may be the best option to manage a bunion.

Please note: Progressive surgeons recommend that conservative management has been tried before operating on a patient so that surgery is always recommended as a last result.

Helpful Links and Resources

Please feel welcome to book an appointment here, or call us on (03) 5298 1147.

Understand and learn more with the following resources:


If you would prefer to learn more in written form:

How Do Orthotics Work?

Written by:
Daniel Monteleone
Podiatrist, Strength & Conditioning Coach
Proactive Health & Movement

Foot & Ankle Pain
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