All you need to know about... bunions

No, it's not just Victoria Beckham who suffers from bunions. Around 50% of UK women experience this painful problem - and it's not always our party shoes that are to blame. Here's everything you need to know about the condition, including how to prevent and treat it...

What are bunions?

'A bunion is an inflamed fluid sac - known as a bursa - that forms on the side of the foot at the base of the big toe,' explains podiatrist Dave Wain, director of Carnation Footcare. 'The joint protrudes because one toe is bent away at an angle, pushing the other toes and causing them to bend unnaturally.' This can prove both painful and debilitating if not properly treated.

Who gets them?

You could be forgiven for thinking Victoria Beckham is the only bunion-sufferer in the world, judging by the amount of column inches devoted to her podiatric plight. 'Actually, bunions are a very common problem, and as many as 50% of women in the UK suffer from them,' says consultant surgeon Mr Robert Lloyd Williams from the London Orthopaedic Clinic.

What causes them?

Research suggests bunions can be hereditary. Your chances of developing them may also increase if you suffer from arthritis, gout or a neuromuscular condition, such as cerebral palsy or multiple sclerosis.

Can shoes cause bunions?

Yes, poorly fitting footwear can also play a part in causing bunions to develop or worsen. 'Tight, narrow shoes and high heels are often to blame,' says Mr Lloyd Williams. And even if your party heels aren't the original root of the problem, continuing to totter around in pointy shoes once a bunion has developed will only aggravate the problem and make it more painful. It's worth noting that bunions are extremely rare in populations that don't wear shoes.

How can I avoid them?

Give flats a chance! According to NHS guidelines, it's best to avoid wearing shoes with high heels or pointy toes. Your shoes should be wide enough for your toes to be forced together and there should be enough room for them to move. So wide-fitting shoes made from soft leather are probably the most sensible choice.

How are bunions diagnosed?

In the first instance, see your GP, who will examine your feet and ask you about your footwear, general health and any family history of bunions. You may also be sent for radiographic imaging to assess the severity of the bunion and decide whether or not you need to be referred to a specialist.

I've got a bunion. What non-surgical treatments are available?

Non-surgical treatments can ease discomfort and pain - although they won't actually get rid of the bunion. Bunion pads and protectors, made from gel or felt, help reduce pressure on the joint. Over-the-counter painkillers can also be used in the short term only.

Any product suggestions?

Carnation Gel Bunion Protectors (£5.10, chemists nationwide) are ideal for long-term sufferers. They contain a mineral oil to moisturise and help soften the skin, and come with toe loops to help position them on the bunion. They can be washed and re-used. Alternatively, Carnation Bunion Pads (£1.68 for four, chemists nationwide) are made from felt, which spreads the load to give maximum comfort; they're shaped to fit around the bunion.

Should I wear insoles?

'If you're flat-footed or tend to over-pronate, it's a good idea to wear insoles, too,' says Lloyd Williams. These can be bought over the counter from chemists. Not sure whether that applies to you? Staff in specialist shops, such as running shoe stores, will be able to help you. Or you could have your feet professionally examined by a podiatrist. You can find your nearest qualified foot specialist at www.feetforlife.org/about-us/find-a-podiatrist.

Could surgery work?

'When non-surgical treatments prove insufficient, surgery can relieve your pain, correct any deformity and help you resume normal activities,' says Lloyd Williams. 'Around 85 to 90% of patients who undergo bunion surgery are satisfied with the results. But be warned: so-called "simple" or "minimal" procedures are often inadequate quick fixes that can do more harm than good. The goal of surgery is to relieve as much pain and correct as much deformity as is realistically possible. It's not meant to be cosmetic."

What does surgery involve?

Lloyd Williams explains: 'The operation may be done under either local or general anaesthetic. The surgeon may take one or more of the following steps to bring the big toe back to the correct position: shift the soft tissue around the join and reset the metatarsal bone, and move the bony bump and other excess bone; or remove the joint and fuse the bones on the two sides of the joint.'

While the main recovery period lasts around six to eight weeks, full recovery is longer, and you may suffer from persistent swelling and stiffness.