A bunion is a bony lump that abnormally forms at the base of the joint on the big toe. This can push against the other toes, causing the big to sit in a different direction from the rest of the foot. If left unchecked, a bunion can enlarge the joint causing pain and excessive crowding of the toes. Bunions are typically caused by wearing shoes that are too tight, but they can also be caused by stressing the foot, medical conditions or a structural defect of the foot. Smaller bunions known as bunionettes can also develop on the smaller toes. Understanding how bunions form and how to treat bunions can help you avoid painful repercussions of this condition.
Bunions will typically cause a large bump to appear on the outside of the big toe. This can cause the joint to become sore, swollen or red. Inflammation may become worse as the bunion affects deeper tissue and skin on the foot. The skin around the affected area may also become thick. As the toes begin to overlap you may become more prone to developing calluses or corns on the surrounding toes. You may find that it becomes difficult to move your big toe as the bunion grows. You may also notice that the pain of the growing bunion can make it difficult to wear shoes or walk comfortably. Over time if a bunion is left untreated it can cause the toes to bend inward, a condition frequently referred to as hammertoe.
Bunions are caused when excess pressure is placed on the foot, or the shifting of your weight falls unevenly on your foot's joints and tendons. Unbalanced pressure can make the joint of the big toe unstable, molding the joint into a lump that will stick out from the normal area of the foot. High heels or other poorly fitting shoes can cause these bumps to appear. Certain inherited foot shapes or deformities present at birth can make you more susceptible to developing bunions. Foot injuries may also alter the way the foot's bearing functions, increasing your risk of this injury. Those that have inflammatory or degenerative diseases that affect the cartilage such as arthritis can put additional stress on the feet, leading to the presence of bunions.
How to Treat Bunions
1. Nonsurgical Bunion Treatments
- Medications. Your doctor may recommend that you take painkillers such as ibuprofen or paracetamol to reduce the pain associated with bunions. These medications should be taken with care, following all instructions to avoid dependency.
- Suitable shoes. Those who have bunions should avoid wearing tight shoes or those with high heels. Select flat shoes with plenty of room for the toes, particularly those made from soft leather that will relieve pressure on the existing bunion. Slip on shoes can also put excessive pressure on the toes, increasing your risk of developing a bunion.
- Bunion pads. Bunion pads are typically made of fleece or gel and are applied to the bunion with adhesive or held in place with a loop fitting over the toe. These pads are designed to relieve pressure at the inflamed joint by preventing the bunion from rubbing against the shoe. To make this bunion treatment more effective, many couple this with ice packs to reduce the swelling of the bunion as well.
- Ice packs. Applying an ice pack to a swollen bunion can help reduce the inflammation and discomfort. Ice packs should be wrapped in a towel or cloth to avoid damaging the skin with excessive cold. Some find that bags of frozen vegetables make ideal ice packs as it is easy to mold these to the shape of the foot.
- Orthotics. Orthotics are devices that are worn inside the shoe to keep the bones in the foot properly aligned, relieving the pressure placed on your bunion. These are not often considered a long-term solution for bunions. Orthotics must fit properly to be effective, so it is important to select a high quality brand or visit a podiatrist to have a custom set made. Bunion splints can also be worn on top of the food to further align the bones. Different splints can be applied for day or night wear, though there is not much evidence that these are affective. Some find that spacers also take the pressure off a bunion, but these cannot be used with orthotics as they compete for space within your shoe.
2. Surgical Bunion Treatments
- Osteotomy. This is one of the most common surgical bunion treatments, which involves cutting part of the bone in the toe, removing part of the bunion lump. This will help the doctors move the toe back into alignment, removing excessive bone as necessary to re-stabilize the foot.
- Arthrodesis. During this procedure the doctor will fuse bones in the joint of the big toe to relieve excess pressure. This is typically recommended for those that have severe deformities of the big toe that would make it difficult for the doctor to properly repair the joint.
- Excision arthroplasty. This surgery requires the doctor to cut the bunion out, replacing it with a false joint that will heal when scar tissue forms after the surgery. Your doctor will need to pin or wire the joint in place, then remove these stabilizers a few weeks after the surgery.
- Minimally invasive bunion surgery. New procedures allow doctors to make a few small incisions on the affected joint, and then use bone-cutting tools to divide the bones and tilt the toe back into place with screws, plates or wires as necessary.