Bunions

What are bunions in children?

A bunion is a deformity at the base of the big toe, where the toe angles inward toward the other toes and a prominent bump develops on the inner side of the foot. While bunions are most often associated with adults, they can develop in children and adolescents — particularly when there's a strong family history.

Juvenile bunions tend to behave differently from adult ones. The underlying anatomy is more often the dominant driver, and the natural history can include worsening over time, particularly through periods of growth.

The decisions around treatment in young people are more nuanced than in adults, particularly around timing and which approaches make sense at which stage.

What does it feel like?

Common features include:

• A visible bump on the inner side of the foot at the base of the big toe

• Big toe angled inward, sometimes overlapping the second toe

• Pain when wearing shoes, particularly narrow ones

• Redness or skin irritation over the bump

• Sometimes secondary problems with the other toes

Symptoms often fluctuate with footwear and activity. Pain isn't always proportional to the size of the bunion.

How is it diagnosed?

Diagnosis is straightforward on examination. X-rays — typically standing weight-bearing views — provide the detail needed to assess the angles between the bones, plan management and track progression.

Assessment also looks at the broader foot shape, footwear, family history and how symptoms are affecting the child. In adolescents with growth still active, the timing of any intervention is part of the conversation.

What are the treatment options?

First-line management is conservative — wider, well-fitting footwear, padding, sometimes orthotic support. These don't reverse the deformity but can manage symptoms effectively in many cases.

Surgical correction is sometimes appropriate for persistent symptoms or progressive deformity. The timing in young people is important — and the technique chosen reflects the specifics of the anatomy. Nev will work through this with you and your child at your consultation, so any decision is well-informed.

When should you get it checked?

Seek a specialist assessment if:

• There's persistent pain at the base of the big toe

• The big toe deformity is progressing

• Footwear has become difficult

• There are secondary problems with the other toes

• You'd like a clear plan and to understand the timing of any options

Bunions in young people are best assessed by someone who understands the long view — what's likely to happen with growth, what conservative measures can achieve, and when intervention makes sense.