It’s summertime. Everyone’s in sandals and flip-flops, and there you are in sneakers, day in and day out because of your bunion. Maybe you’re embarrassed, maybe you’re in pain, maybe both. But I’m here with some good news—bunions are treatable, and quite easily so.
What Is a Bunion?
You know it as that lumpy thing on your big toe, but what is a bunion, exactly? A bunion—also known as a hallux valgus deformity—is a painful, bony bump on the inside of the big toe (also known as the hallux). It causes the big toe to drift toward the second toe.
Symptoms include visual deformity—the big toe is not straight—and pain. Walking may be difficult, and sometimes there are corns on the bump.
What Causes Bunions?
The exact cause of bunions is unknown, but foot and ankle specialists recognize a number of possible causes. There might be a genetic aspect to developing bunions. Foot injuries and congenital deformities are also likely suspects.
There are also risk factors for bunion development. Some you can avoid, some you can’t. Some of these include:
- Footwear: High heeled shoes and shoes with tight toe boxes are often associated with bunion
- Rheumatoid arthritis: This type of arthritis is inflammatory and can make you more likely to develop a bunion
Misconceptions About Bunions
Many people believe that only women get bunions, but that’s not true; about 13 percent of men have bunions, according to a 2011 systematic review and meta-analysis. The misconception may be because women are more likely to have been jamming their feet into pointed-toe high heels for years. Also, women are about three times more likely as men to develop rheumatoid arthritis, a risk factor for bunions.
When you have a bunion, you’ll likely know it. The bump at the joint of your big toe—that joint is the metatarsophalangeal, or MTP, joint—and likely painful. Other symptoms can include:
- A callus or corn on the bump
- Hardened skin on the sole of the foot
- Inflammation and redness at the bunion site
- Stiffness and difficulty walking
Tips for Treating Bunion Pain
So, if you have a bunion, what can you do about it? You actually have a number of options, many of which do not involve surgery. Although non-operative care cannot actually get rid of a bunion, it can reduce the pain and prevent the bunion from getting worse.
Change your shoes. This is the big one. Most bunions can be successfully managed with a simple change in footwear. Here are some tips for selecting bunion-friendly shoes:
- Avoid high heels and shoes with a narrow toe box
- If you’re like most people who have one foot bigger than the other, select shoes based on the size of the larger foot
- Make sure your toes have enough room in front, and that there is little heel slippage; in other words, make sure your shoes fit right
- Stand during the fitting process and walk around in shoes for a while before you buy them
Check out inserts. When it comes to shoe inserts, there are a few choices. You can buy a bunion shield, which is a pad that slips over the big toe and helps keep the pressure off the bunion when you’re wearing shoes. Over-the-counter (OTC) or custom orthotics—shoe inserts—are another option. Many look like bunion shields that have additional toe spreaders that help hold the foot in a natural position.
Take your medicine. Since bunions are sometimes aggravated by inflammation, certain OTC and prescription drugs may help. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen can reduce the pain caused by bunions. If your bunion is being aggravated by rheumatoid arthritis, the medication you’ll take to manage your arthritis can also help with your bunion.
Bunion Correction Surgery
If these conservative measures don’t prove effective, it may be time to consider surgery. You may have heard that bunion surgery is painful and recovery is difficult. While there may be a long recovery involved—up to six months, in some cases—it is certainly better than living with a painful bunion for the rest of your life!
Most bunion surgeries have three goals:
- Correcting bunion-caused deformities
- Easing pain
- Realigning the MTP joint
Most surgeons will use one of or a combination of the surgical techniques below to achieve these goals. Possible surgeries include:
- Exostectomy: bump removal
- Osteotomy: cutting into the bone to realign the joint
Because the recovery from bunion surgery can take a long time and because there may be some restrictions after the surgery—what kind of shoes you can wear, for instance—deciding to get surgery must be considered carefully. Talk to your surgeon to get the facts and decide the best course of action together.
In my practice, I have corrected hundreds of bunion deformities and have seen firsthand how my patients’ lives improve when they are free of foot pain. Request an appointment with me or one of my colleagues to learn about your bunion treatment options.