A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoes.
Many of our patients with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Because they are bone deformities, bunions do not disappear by themselves. The goal for bunion treatment is twofold: to relieve the pressure and pain caused by irritations and to stop any progressive growth of the enlargement.
If you have a bunion, you're not alone! It is estimated that 33% of the populations of Western countries have bunions.
Causes of Bunions
- Although not hereditary, they do tend to run in families because of faulty foot structure
- Flat feet
- Neuromuscular problems
- Occupations that require you to place great strain on your feet
- Pronated feet (feet that roll inward when walking or running)
- Wearing shoes that are too tight
Symptoms of Bunions
- A bony bump on the side of your foot at the base of the big toe
- Corns or other irritations caused by the overlap of the big and second toes
- Pain, redness, or swelling at the metatarsophalangeal joint
- Restricted or painful movement of the big toe
Conservative Treatment for Bunions
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth
- Exercises to maintain joint mobility and prevent stiffness or arthritis
- Orthotic devices—both over-the-counter and custom-made—to help stabilize the joint and place the foot in the correct position for walking and standing--NOPA offers more than 150 unique custom-made orthotics
- Protective padding, often made from felt material, to eliminate the friction against shoes and to help reduce inflammation and skin problems
- Removal of corns and calluses on the foot
- Splints for nighttime wear to help the toes and joint align properly (This is often recommended for adolescents with bunions because their bones are still developing and may be adaptable.)
Surgical Treatment: When Conservative Care Is Not an Option
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe. With over 26 years of surgical experience, Dr. Edward Lang, our board-certified surgical specialist, has performed thousands of successful foot and ankle proceedures. To ask a question or to learn more about the benefits of bunion treatment or bunion surgery, send us a question via the "Ask A Question Now" link or call our office today at (504) 897-3627.