Q: What are bunions? How do you treat them?

It tends to be more common in women who have a family history of bunions and is seen in a lot of people who wear ill-fitting shoes.

It is commonly associated with wearing shoes which weaken some of the muscles of the foot. There are some shoes that put an awful lot of strain on the forefoot and particularly the very high heeled type, which puts more stressful force through the toes, causing more troubles in and of themselves.

As you develop a valgus deformity of the big toe, a bunion, you then put more strain onto the little toes.

Bunions usually develop slowly over time and can cause pain and a restriction in movement, and can eventually result in arthritis of the foot and toes.

For advanced cases of hallus valgus (such as when a person is unable to walk due to their bunions) surgery can realign the bones, ligaments, tendons and nerves of the affected joint. This is a day procedure and takes up to six months for recovery.

Part of the non-operative management for bunions is to find a shoe that really fits. It's a real trick to find a shoe that's both aesthetic and that can accommodate the foot. This can be hard work because a practical viewpoint our society expects people to wear a certain style of shoe - particularly women in professional contexts.

If we didn't wear shoes, I think there would be a whole lot more other injuries, so shoes are still necessary, but we do need to be careful that we find footwear that does actually fit the feet rather than just look good.

To minimise the chance of developing bunions, the American Orthopaedic Foot & Ankle Society recommends wearing shoes wide insteps, broad toe boxes and soft soles. Feet shouldn't be forced into shoes that don't fit, and high heels should be under 6cm tall. To relieve discomfort for those who have already developed bunions, cushioning products are available from pharmacies and podiatrists.

Who to see about a pain in the foot

If you present to your GP with foot problems you may be offered the option between a podiatrist and an orthopaedic surgeon.

Podiatrists are allied health professionals who are trained in restoring function to the foot and ankle. They can assess and treat problems like nail and fungal issues, corns and callouses, gait (or walking) issues, as well as care for feet affected by diabetes and arthritis. For advanced cases a podiatrist can refer patients to an orthopaedic surgeon.

Orthopaedic surgeons do not always operate (despite the name 'surgeon'), and while they provide operative and non-operative treatment for issues of the bones, joints and tissues they often specialise in one area. In the case of foot issues, it is best to see a specialist foot and ankle orthopaedic surgeon in order to ensure the correct advice is recommended early in your treatment.

In either case, your GP will be able to advise you on the best medical professional to treat your condition. Looking after your feet is an important part of your overall health.