What Is a Bunion?
A bunion is often described as a bump on the side of the big toe. The visible bump is the result of changes in the bony framework of the foot. For this reason, the big toe leans in, rather than pointing straight ahead.
Bunions are a progressive issue, meaning they change and develop over time. They begin with the leaning of the toe, but gradually begin to change the angle of the bones resulting in the increasingly prominent bump.
Symptoms, which occur at the site of the bunion, may include:
Pain or soreness
Inflammation and redness
A burning sensation
Symptoms usually occur when wearing shoes that crowd and squeeze the toes ex. high heels. Consequently, bunion symptoms are more likely experienced by women than men. Extended periods of time spent on your feet can also contribute to bunion symptoms.
Bunions are usually caused by an inherited faulty mechanical structure of the foot. It’s not the bunion itself that is inherited but certain foot types that make a person more prone to developing a bunion.
Although wearing shoes that crowd the toes will not actually cause bunions, it can exacerbate the issue and may cause symptoms to appear sooner.
Bunions are fairly simply to identify —the prominence is visible at the base of the big toe or side of the foot. However, the foot and ankle surgeon may take x-rays to fully assess the condition, determine the degree of the issue, and assess the changes that have occurred.
Because bunions are progressive, they do not go away and will usually get worse over time. But not all cases are alike—some bunions progress faster than others. Once your surgeon has evaluated your bunion, they’ll develop a treatment plan that is suited to your specific needs.
Sometimes observation of the bunion is all that is needed. To reduce the chance of damage to the joint, your surgeon will most likely request periodic evaluation and x-rays.
In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions. These include:
Changing footwear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels, which may aggravate the condition.
Padding. Pads placed over the area of the bunion can help minimize pain.
Changing activities. Avoid activity that causes bunion pain ex. standing for long periods of time.
Medication. Oral anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
Icing. Applying an ice pack several times a day can help reduce inflammation and pain.
Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
Orthotic devices. In some cases, custom orthotics may be provided by your podiatrist.
When is Surgery Needed?
If nonsurgical treatments do not relieve bunion pain and when the pain of a bunion interferes with daily activities, it’s time to discuss surgical options with your foot and ankle surgeon and decide if surgery is best for you.
A variety of surgical procedures are available to treat bunions. The procedures are designed to remove the bump of bone, correct the changes in the structure of the foot and correct any soft tissue changes that may have occurred. The goal of surgery is the reduction of pain and deformity.
To determine the right course of action for your case the surgeon will consider the degree of your bunion formation, your age, activity level, and other lifestyle factors. Recovery time will vary depending on the procedures performed.