Bunions ( Hallux abducto valgus or HAV)
Bunions present themselves as a bony prominence over the big toe joint and the big toe will appear deviated towards the smaller toes. Bunions are caused by a malalignment of the big toe joint usually due to poor foot function. As the big toe bends towards the others this lump becomes larger and the bunion can become painful and arthritis and stiffness can eventually develop.

 Poor fitting footwear or footwear that is too tight is most commonly cited as the cause of bunions (hallux valgus) and can be a contributing factor. However, it is more widely considered that the main cause of bunions is poor or abnormal foot function. This abnormal function can cause an imbalance in the forces that are exerted across the joint during walking and can eventually lead to instability in the joint causing bunions.

Bunions are not inherited, but do tend to run in families. Just the same way you inherit your parents’ eye, hair and skin colouring, the same goes for foot type and foot function. Inheriting poor foot function can mechanically lead to the instability around the joint that leads to bunions. People with flat or excessively pronated feet are often more prone to bunions.

Treatment of bunions
Once a bunion has formed, there is no effective way to get rid off it without surgery. However, your podiatrist can advise you on the treatment options available to relieve pressure on the bunion and slow the progression of the joint deformity. These options may include some or all of the following:

• Padding, such as felt, or gel based pads to reduce pressure on the bunion.
• Physical therapy and/or exercises to help with the symptoms and improve the range of motion in the joint
• Advice on correct fitting of footwear. Wear wide shoes that fit comfortably around the bunion and avoid wearing high heel shoes as these can create pressure on the ball of the foot and bunion.
• Getting your shoes stretched in the area of the bunion to help relieve pressure. Most shoe repair shops are able to do this for you.
• Foot orthotics to help improve foot function 
• Bunion surgery if the bunion is not responding to conservative treatment options or it has become necessary to correct alignment and remove the bunion. You will need to discuss the range of surgical options with your podiatrist and/or orthopedic surgeon.

Corns and Callouses

Corns and callouses are among the most common foot complaints and are due to an excessive build up of hard skin caused by pressure often from footwear or abnormal foot function. This is your body’s natural protection mechanism, to create an area of hard skin to protect the underlying tissues from excessive stress. Problems occur when the pressure continues and the skin gets thicker and thicker to protect itself. Eventually the area can become painful.

A callus generally refers to a flat, more diffuse build-up of hard skin and may or may not hurt depending on its thickness.

A corn is a thicker more focal area with a central nucleus or core which forms over a bony prominence such as a joint. Corns occur more commonly on the toes and can often be very painful.

Corns and callus are caused by one thing - TOO much pressure, often in combination with some friction. Too much pressure can be caused by:

• Footwear that is too tight
• Toe deformities, such as hammer toes - the top of the hammer toe is an area for increased pressure on the top of the toe
• A bony prominence
• Biomechanical or gait abnormalities that cause pressure under different areas of the bottom surface of the foot (this is a common cause of callouses)

Treatment of corns and callouses

Corns and callus will not come right on their own unless the pressure that caused them is removed. You need to ensure your footwear fit properly and that you maintain good foot hygiene and use skin emollients to keep the skin in good condition.

Be careful of over the counter remedies such as corn paint or corn plasters. These normally contain acid that help to 'eat away' the corn, but the acid can not tell the difference between a corn and normal skin and it will eat away what ever you put it on. Use of these types of remedies can be very dangerous and risky in those with poor circulation and/or diabetes and is not recommended.

Do not try to cut away corns and callouses yourself. They can be removed painlessly by your podiatrist with immediate relief. Your podiatrist can also advise you how to best prevent new corns and callouses forming which may include some or all of the following options:

• Regular maintenance to keep the corn and callouses reduced
• Use of padding to prevent the pressure
• Advice about correct fitting of footwear
• The use of foot orthotics to relieve the pressure under the foot
• Surgical correction of the bony prominence that may be causing the high pressure area

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