What is a bunion?
A bunion is a bump that forms on the outside of the big toe. This foot deformity occurs from years of pressure on the big toe joint (the metatarsophalangeal/MTP, joint). Eventually, the toe joint gets out of alignment, and a bony bump forms.
Who might get a bunion?
Bunions are more common in women but can occur at all ages and in men. Bunions can form on one or both feet.
What causes bunions?
Pressure from the way you walk or the shape of your foot causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem. You may be more likely to get a bunion if you have:
- Family history of bunions due to inherited foot structure problems, like flat feet.
- Foot injuries.
- Inflammatory diseases, such as rheumatoid arthritis
What are the signs and symptoms of bunions?
- Bunions tend to be red and swollen. Other symptoms include:
- Inability to bend your big toe, or pain and burning when you try to bend it.
- Difficulty wearing regular shoes.
- Corns or calluses (thickened skin).
- Hammertoes (painful, tight toe tendons and joints).
- Numbness in the big toe.
How are bunions diagnosed?
Your healthcare provider can diagnose a bunion by looking at it. Often an X-ray is needed to check for joint damage and bone alignment.
How are bunions managed or treated?
Bunions don’t go away. Treatment often focuses on relieving symptoms and may include:
Bunion pads and taping
Over-the-counter bunion pads can cushion the area and ease the pain. You can also use medical tape to keep the foot in the correct position.
Footwear changes
Switching to shoes with wide, deep toe boxes can take pressure off of your toes. You may be able to use a stretching device to widen shoes you already own.
Orthotic devices
Over-the-counter or custom-made shoe inserts (orthotics) can help to control alignment issues such as pronation that may be contributing to bunion formation when wearing them. You can also place a spacer between the big toe and second digit. Some people find relief by wearing a splint at night to keep the big toe straight. This said these are temporary symptomatic relief measures and bunions can NOT be reversed this way.
Pain relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs) both oral and topical can be combined with ice packs to help with pain and swelling.
Physical therapy
Massage, physical therapy and ultrasound therapy can break up soft-tissue adhesions to reduce pain and inflammation. There are actually exercises that can help improve muscle strength around the bunion and however this does not improve alignment.
Injections
Steroid injections may reduce pain and swelling but may also be damaging if used too often or injected into the joint itself. This is often a late treatment of ARTHRITIC bunions when trying to avoid surgery.
Surgery
If nonsurgical treatments don’t help, and walking becomes extremely painful, your provider may recommend surgery. This procedure is called a bunionectomy. Your provider removes the bunion AND realigns bones to bring the big toe back into the correct position making recurrence less likely. This can now be performed in a minimally invasive keyhole technique improving recovery times and cosmesis of deformity and surgical scars. Without the right care, like changing your footwear or using orthotics, bunions can get worse over time. If you have severe pain when you walk or stand, you may become sedentary (inactive), which isn’t good for your health or quality of life. Most people get symptom relief with over-the-counter aids or through treatments at a medical office. If needed, surgery can help. Contact Dr. Daniel Nunes for more information on treatments for bunions.