Bunions

What are bunions?

The most common type of bunion, called hallux valgus, is a bony bump that forms on the side of the foot at the base of the big toe. It happens when the bones in the front of the foot shift out of place, causing the big toe to lean toward the smaller toes and the joint to stick out. The bump may initially be small but can gradually enlarge over time.

In some instances, the big toe may press against the second toe, leading to overlap or misalignment. As the condition progresses, the shape of the foot may change, and the bump becomes increasingly noticeable.

A less common form, known as a bunionette, is a smaller bump that forms on the joint of the little toe. This happens when the bones in the foot shift, causing the little toe to tilt inward and the joint at its base to stick out.

What are the different types of bunions?

There are six types of bunions, each varying in severity. Treatment depends on the specific type, symptoms, and level of discomfort.

Regular (or Common) Bunion

This is the most common type, where a bump forms on the side of the big toe. It causes the toe to lean inward, toward the other toes.

Bunionette (or Tailor’s Bunion)

Similar to a regular bunion but occurs on the outside of the foot at the base of the little toe. This can also cause discomfort and swelling, but it’s less common than a big toe bunion.

Inflammatory Bunion

These are bunions associated with conditions like rheumatoid arthritis or gout, where inflammation contributes to the development of the bunion. Inflammatory bunions can be more painful and may develop faster than other types.

Flexible Bunion

A bunion where the big toe still has some range of motion, and the bump may not be as pronounced. It may be easier to treat in early stages.

Stiff Bunion

This occurs when the joint becomes rigid and less flexible, often due to arthritis or long-term pressure. This type of bunion is more difficult to treat and might require surgery.

Congenital Bunion

Some people are born with a greater probability to developing bunions due to the structure of their feet, even though the bunion itself may not appear until later in life.

What are the symptoms of bunions?

Signs and Symptoms include:

• A bulge or protrusion on the outer side of the joint at the base of the toe
• Discomfort or tenderness in the toe, leading to foot problems
• Swelling, redness, or soreness around the toe joint
• Corns and calluses
• Difficulty moving or bending the big toe
• Difficulty wearing regular shoes, or pain that gets worse when wearing shoes
• Numbness or tingling in the toes
• Hammertoes

How do you get bunions?

Bunions can develop for several reasons, including genetics, as a family history of bunions increases the likelihood of developing them. Foot shape also plays a role, with people who have flat feet or high arches experiencing added pressure on the big toe joint. Wearing tight, narrow, or high-heeled shoes can force the toes into unnatural positions, contributing to bunion formation. Arthritis, particularly rheumatoid arthritis, can damage joints and misalign foot bones, leading to bunions. Injuries such as fractures or sprains may also shift bones and cause bunions. Additionally, abnormal walking patterns that put excessive pressure on the big toe over time can contribute to their development.

How are bunions treated?

There are various treatment options available depending on the severity of your bunion and your specific needs.

At home treatments

• Footwear changes: Wearing comfortable shoes with a wide toe box that don’t squeeze or press on any part of your foot can help reduce bunion pain. Look for shoes with soft, flexible materials to minimize pressure on the affected area.
• Icing: Applying an ice pack to the bunion for 15-20 minutes a few times a day can reduce swelling and pain.
• Pain relievers: Over-the-counter medications like ibuprofen or acetaminophen can help manage pain and reduce swelling. NSAIDs, such as ibuprofen, are particularly effective for inflammation relief.
• Padding and orthotics: Using shoe pads or custom orthotic inserts can protect the bunion from friction and improve foot alignment, helping to alleviate discomfort.

Professional treatments

If at-home remedies don’t provide sufficient relief or if the bunion becomes more severe, your doctor may recommend professional treatments.

• Physical therapy: Exercises that increase the range of motion of the joint and strengthen the foot muscles can help reduce pain and improve foot function.
• Corticosteroid injections: For persistent swelling and pain, corticosteroid injections can offer stronger relief by reducing inflammation. These are typically used in more severe cases when other treatments haven’t been effective.
• Traditional bunion surgery: In the most severe cases, surgery may be required to realign the bones, remove the bony bump, and restore normal foot function. Surgery is usually considered when other treatments are ineffective or the bunion significantly impacts mobility and daily life.
• Lapiplasty: A modern surgical technique that realigns the bones and corrects the bunion at its root cause. Unlike traditional bunion surgery, Lapiplasty involves a 3D correction of the bone structure, providing long-term relief with faster recovery times. This treatment is often recommended for severe bunions or when conservative measures fail.

How can I prevent bunions?

To prevent bunions, it’s important to wear proper shoes with a wide toe box and avoid high heels. Using orthotic inserts can help improve foot alignment, while foot exercises can increase flexibility and strength. Maintaining a healthy weight reduces pressure on the feet, and taking breaks when standing for long periods can also help. Ensuring proper foot alignment during activities is essential for prevention.

These actions can reduce the risk of bunions or slow their progression, and your podiatrist can recommend suitable types and brands of shoes to meet your needs.

Will bunions go away on their own?

Simply put, no.

Bunions tend to worsen over time if not managed properly. While the pain and swelling can sometimes be temporarily relieved with conservative treatments like ice, pain relievers, or proper footwear, the bony bump itself is unlikely to disappear without intervention. In fact, without proper care, the deformity may get larger and cause more pain or other issues like misalignment of the toes.

It’s important to monitor your symptoms and talk to a healthcare professional about the best approach for your situation.

When is it time to see a podiatrist for bunions?

You should consider seeing a doctor if you experience any of the following:

• If the severe or constant pain interferes with daily activities or doesn’t improve with home treatments.
• If the bump becomes more pronounced over time or the shape of your foot changes.
• If walking or standing becomes painful or difficult.
• If the bunion becomes swollen, red, or inflamed and doesn’t improve with rest or ice.
• If the big toe starts pressing against the second toe, causing it to overlap or become misaligned.
• If changes in footwear, padding, or pain relievers don’t ease the discomfort.

Seeing a podiatrist, like the experts at Volunteer Podiatry, is key to determining the best treatment for your condition. Our team can provide personalized advice and treatment options to help manage bunions and prevent further complications.