Bunions
Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes resulting in the bunion bump. This deformity may gradually increase and cause pain while wearing shoes or walking. Anyone can get a bunion but they are more common in women. Bunions often develop in both feet.
Causes
Bunions may be caused by:
- Wearing poorly fitting shoe, in particular, shoes with a narrow, pointed toe box that forces the toes into an unnatural position
- Heredity—some people inherit feet that are more likely to develop bunions due to their shape and structure
- Having an inflammatory condition, such as rheumatoid arthritis, or a neuromuscular condition, such as polio
- Laxity of the ligaments of the foot
Symptoms
In addition to the visible bump on the inside of the foot, symptoms of a bunion may include:
- Pain and tenderness
- Redness and inflammation
- Hardened skin on the bottom of the foot
- A callus or corn on the bump
- Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
Nonsurgical Treatment
In most cases, bunions are treated without surgery. Although nonsurgical treatment cannot actually “reverse” a bunion, it can help reduce pain and keep the bunion from worsening.
Changes in Footwear
In the vast majority of cases, bunion pain can be managed successfully by switching to shoes that fit properly and do not compress the toes. This involves choosing wide fitting shoes.
Some shoes can be modified by stretching. This can be done by a shoe repairer who will stretch out the areas of the shoe that put pressure on the toes. The doctor can give patients information about proper shoe fit and the type of shoes that would be best for them.
Padding
Protective “bunion-shield” pads can help cushion the painful area over the bunion. Pads can be purchased at a pharmacy. It is necessary to test the pads for a short time before using them for long periods. Be aware that some pads may worsen pain rather than reduce it. Selection of pads may require some trial and error by patients until the right pads are found for their feet.
Orthotics and Other Devices
To take pressure off the bunion, the doctor may recommend wearing over-the-counter or custom-made shoe inserts (orthotics).
Toe spacers can be placed between the toes. In some cases, a splint worn at night that places the big toe in a straighter position may help relieve pain.
Medications
- Paracetamol can be helpful.
- Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can also help relieve pain and reduce swelling.
- Other medications can be prescribed to help pain and swelling in patients whose bunions are caused by arthritis.
Surgical Treatment
When non-surgical measures prove inadequate surgery may be considered. See the section on this website for surgical procedures for the treatment of bunions.