Bunions are a common problem of the forefoot. A bunion is an enlargement of the metatarsophalangeal (MTP) joint or the joint at the base of the big toe. When the big toe is bent or pushed up against the other toes (due to heredity or crowding caused by shoes that are too tight), an abnormal, bony bump can form at the MTP joint on the outer portion of the foot. This bump is caused when the MTP joint is moved out of alignment in the opposite direction of the big toe. Over time, this abnormal angle causes the joint to continue to enlarge – becoming very prominent and painful, if it’s not treated.
Smaller bunions, called bunionettes or tailor’s bunions, also can form on the opposite side of the foot along the lateral side of the little toe joint, called the 5th metatarsophalangeal joint.
What Causes Bunions to Form?
Bunions can develop for a number of reasons, including:
- An inherited structural defect of the foot that causes stress on the foot, often leading to bone and/or joint deformities.
- Medical conditions, such as inflammatory or degenerative arthritis.
- Wearing shoes that are too tight, too narrow, too pointed, or high-heeled, causing the toes to be squeezed together. Bunions are a common disorder among women due to the design of women’s shoes which in turn is a crude form of foot binding.
- Inherited foot type, such as hyper-flexible flat feet, low arches, and/or a condition known as forefoot valgus deformity. These conditions cause poor biomechanical function of the foot.
- From stress being placed on the feet due to a person’s occupation, such as someone who stands all day on concrete or asphalt, or a ballet dancer.
What Are the Symptoms of Bunions?
Some common symptoms of bunions may include:
- Inflammation and redness at or near the MTP joint.
- Constant or periodic pain.
- Restricted or painful movement of the big toe.
- A burning sensation in the area.
- Possible numbness of the area.
- The development of corns or calluses caused by the overlapping of the big toe and second toe created in the later stages of this deformity.
Eventually, the pain from a bunion can become severe, making it uncomfortable to wear or walk in normal shoes. Over time, hammertoe and overlapping toes may develop due to the crowding and bending of the toes and forefoot.
Diagnosis and Treatment of Bunions
You should visit your orthopedic doctor or podiatrist if you have a visible bump on your big toe joint and any symptoms. Your doctor may take x-rays to determine the extent of the deformity. Proper treatment should be discussed.
Treatment options vary with the type and severity of the bunion. The primary goals of treatment are to reduce pain and pressure on the bunion and to stop the development of joint deformity. Treatment may include:
- Changing your footwear – You should wear shoes with a wide toe box that are comfortable on your feet. Avoid shoes with pointed toes or high heels over two inches tall.
- Check your fit yearly and learn to fit to the arch length of your foot and not the toe length when buying shoes.
- Padding and taping – You can place a non-medicated pad around the bunion to reduce pain. Also, you can tape your foot to keep it in a normal position to reduce stress on the foot and pain.
- Ice – You can apply ice packs several times a day to reduce inflammation and pain.
- Activity restrictions – You should avoid activities that cause pain, like walking or standing for long periods of time without the use of proper footwear.
- Medication – Nonsteroidal anti-inflammatory drugs, like ibuprofen, may be recommended to reduce pain and inflammation. Cortisone injections also may be useful. However, these medications and treatments usually only provide temporary relief.
- Orthotics – Shoe inserts, like the ezWalker® Performance Insole, can help relieve, and in some cases eliminate, pain and reduce the symptoms of bunions. The ezWalker® custom insole strategically supports your medial, lateral, and trans-metatarsal arches and helps to relieve pressure on the ball of the foot. Its biomechanical design enhances your foot’s position by supporting the hind foot in a way that realigns the forefoot for the propulsion phase of the gait cycle. This redistributes pressure as you walk, and therefore, helps to prevent the worsening of the deformity. Each ezWalker® Performance Insole is custom molded to the specifications of each of your feet, providing you with pain relief and comfort. Ultra-thin, 3/4 length ezWalker® custom orthotics fit in a wide variety of shoes, too.
- Surgery – If conservative treatments, like those described above, don’t provide symptom relief, or if your deformity is severe, you may require a bunionectomy to remove the bony enlargement and realign the MTP joint.
Because … when your feet feel good, you feel good.
Note: If you follow these guidelines and your pain persists, you may have a more serious condition. See your physician for a more complete diagnosis and treatment.