Bunions

bunionWhat is a bunion?

A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping another toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallux Abducto Valgus. Bunions can also lead to other toe deformities, such as Hammertoes.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, arthritis may set in, the skin on the bottom of the foot may become thicker, and every day walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight can cause the bunion to hurt more. Bunions are believed to be hereditary, so look at your parents and grandparents feet! Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because bunions are a bony deformity, they do not resolve by themselves. The goal for bunion treatment is two-fold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

  • The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
  • Removal of corns and calluses on the foot.
  • Changing to carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth.
  • Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in a more correct position for walking and standing.
  • Exercises to maintain joint mobility and prevent stiffness or arthritis.
  • Splints for nighttime wear to help the toes and joints align properly.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe. Please see our section on bunion surgery.