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    Beating Bunions

    Jason Denton, DPM Deaconess Clinic Podiatry 04/11/2019

    Every day in my practice, I see patients who are suffering from large, painful bunions. The condition is common, affecting as many as 1/3 of all adults. Many times bunions don’t require professional treatment, but when they do, a podiatrist can play an important role in addressing the issue.
     
    What are bunions?
    Bunions are commonly referred to as a “bump” on the joint at the base of the big toe – the metatarsophalangeal (MTP) joint. They form when bone or tissue at the MTP joint moves out of place and the big toe is forced to bend toward the other toes, causing a painful bump of bone on the foot. Because this joint carries a lot of the body's weight while walking, bunions can cause extreme pain if left untreated.
     
    What causes bunions?
    Bunions form when the normal balance of forces exerted on the joints and tendons of the foot become disrupted. This disruption can lead to instability in the joint and cause the deformity. Bunions form after years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and usually caused by the way we walk, our inherited foot type or our shoes.

    Bunions definitely tend to run in families; however, it is the foot type or poor foot mechanics that are passed down to the next generation--not the bunion.  

    Other causes of bunions are foot injuries, neuromuscular disorders or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.

    Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor in patients with bunions. This helps explain the high prevalence of the disorder among women, who often wear pointy-toed shoes.
      
    Symptoms of a bunion
    The key symptom of someone with a bunion is the growing bump on the inside edge of the foot, below the big toe. Other symptoms include:
    •Development of a swelling, callus or firm bump on the inside edge of the foot, at the base of the big toe
    •Redness, swelling, or pain at or near the MTP joint (the joint where the big toe and foot meet)
    •Restricted or painful motion of the big toe
    •Appearance of corns between the first and second toes due to friction generated from the overlap of toes.
     
    Home remedies for bunions
    The primary goal of most early treatment is to relieve pressure on the bunion and halt the progression of the joint deformity. A lot of these processes can be completed at home before calling a physician. For example:

    • Apply a commercial, non-medicated bunion pad around the bunion
    • Apply a spacer between the big toe and second toe
    • Wear shoes with a wide and deep toe box (no pointy shoes!)
    • If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling 
    • Try creams and other topical anti-inflammatories for some relief
    • Avoid high-heeled shoes

    If pain persists despite the at-home treatments, it’s time to see a podiatrist.
     
    Medical treatment for bunions

    Non-surgical

    • Padding and taping: Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain.
    • Medication: Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation caused by joint deformities.
    • Physical therapy: Often used to provide relief of the inflammation and bunion pain.
    • Orthotics: Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity. We have an excellent orthotic lab here at Deaconess Clinic, and I’ve seen many patients get relief from all types of foot issues—including bunions—by getting corrective orthotics.

    Surgical

    When other treatments aren’t adequate, or the bunion progresses, foot surgery may become necessary to relieve pressure and repair the toe joint.

    A simple bunionectomy, in which only the bony prominence is removed, may be used for mild to moderate deformities. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint.

    Recuperation from surgery takes time. Most patients experience swelling and some discomfort for several weeks following surgery. Medications prescribed by your podiatrist can help manage pain, but for the best outcome, I highly recommend following the postoperative instructions provided by your doctor.
     
    Ways to prevent bunions
    There are several ways to prevent or at least slow the progression of bunions. They include:

    • Avoid shoes with a narrow and/or pointy toe box
    • Wear supportive shoes, and if necessary, get custom orthotics. Those with “flat feet” should especially consider orthotics.
    • See your podiatrist at the first signs or symptoms of a bunion deformity, as early treatment may stop or slow its progression.


    If this information made you realize that you need to be evaluated for your bunion(s), you can schedule a new patient appointment with a Deaconess podiatrist online. If you are a current podiatry patient, you can schedule an appointment through MyChart

    Learn more about our services, locations and contact information on the Deaconess Clinic Podiatry page.
     
    Some of the content in this blog is from the American Podiatric Medical Association. 

    Learn more about the author

    Jason Denton, DPM
    Specialty: Podiatry
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