Bunion: Causes, Symptoms & treatment

Medically Reviewed By : Dr K. Hari Chandana

MBBS, MS ORTHOPAEDICS
( Fellowship in Trauma, Fellowship in Pain Management )

Introduction

Have you ever heard of bunions? Are you experiencing painful bony bumps or changes in the shape of your big toes? Bunion or hallux valgus, is the most commonly seen foot anomaly where your big toe deviates towards the adjacent toes, causing joint misalignment and painful, bony bumps. Our big toes are made of two joints. A bunion occurs on the metatarsophalangeal joint (MTP joint). This is more commonly seen in adults, especially women. 1 in every 3 women will experience this at some point in their lives. Your healthcare provider can diagnose it by just examining it. Here we will see in depth the causes of a bunion, symptoms and treatment.

In This Article

What is a bunion?

Bunion or hallux valgus, is a condition where a bony bump is formed at the base of your big toe causing it to lean towards other toes and may deform them too. Some bunions can be painful. It can be caused by many reasons such as tight shoes, foot stress or arthritis. The skin on the sides of the big toe becomes thick and hard. Often the big toe joint may be red and swollen, and sometimes it also becomes harder to move the big toe. There are different types of bunions, they include the following:

Congenital hallux valgus: It is a type seen in newborn babies. Some are born with bunions.
Juvenile or adolescent hallux valgus: Here in this type the bunion is seen in teens. Some develop bunions at the age group of 10 and 15.
Tailor’s bunion: This is also called a bunionette, here the bunion forms on the outside base of the little toes.

What are the causes of bunion ?

Several risk factors can add up to increase the formation of bunions. As we age, change will occur in our feet too. Let’s look into some of the risk factors.

Bunions are more common in women than men.
Wearing poorly fitting shoes, which are narrow, pointed-toe, and high-heeled that force the toes to crowd.
Heredity is an important factor; people inherit the type of feet that are more likely to develop bunions due to their shape and structure, such as flat feet.
Many health conditions can lead to bunions such as rheumatoid arthritis, or other conditions such as polio.
Foot injuries, abnormal muscle insertion
Anatomical or biomechanical factors such as long first metatarsal, rounded joint, metatarsus primus varus.

What are the symptoms of bunions?

A bunion develops over time. This consists of bone deviation and destabilization of the group of muscles around the joint. The bony bumps may or may not be painful. Each person can have different symptoms. Some of the most reported bunion symptoms are:

Formation of a bony enlargement in the first metatarsal joint of the toe.
Initial pain and pain of the toe joint with certain footwear.
Changes are seen in the skin over the bunion such as becoming hard, warm and red.
There may be an increase in pain as the bunion size increases.
The patient will tend to keep their weight on the lateral border of the foot as the bodyweight moves forward on a foot on the ground.
There is a late rise in the heel due to body weight being shifted onto the lateral border of the foot.
Single-limb support time is reduced.
Weakness is found in the hallux abductor muscles and the shortening of the flexor hallucis brevis muscle.

How do you treat bunions?

A bunion treatment can include various non-surgical as well as surgical procedures. In most cases, bunions are cured without any surgery. If they are painless, they can be monitored and non-surgical measures can be adopted to prevent it from worsening. Bunion gets worse over time if proactive measures are not followed on time. The treatment measures will depend upon the severity, symptoms, type of deformity and other medical conditions such as diabetes, vascular disease or rheumatoid arthritis. The non-surgical treatments to relieve symptoms are bunion splints, bunion sleeves, bunion gel pads or moleskin pads, painkillers and injections.

Bunion splints: They are also called the toe spacers or toe supports which are used to keep the toes in proper position. This will help in relieving the symptoms and retard the bunion progression. This splint wraps around the big toe and foot. This is similar to a bunion sleeve. Splint aims to straighten the toes temporarily, reducing the discomfort and pain. This can’t be worn along with shoes so is usually worn at night time.

Moleskin pads or bunion gel pads, act as a cushion by covering the bunion and other pressure points. This will protect the bunion from irritation and other discomfort.

Bunion sleeves are called bunion correctors slides. Like the moleskin pads, the sleeves also protect the bunion from irritation and rubbing inside the shoes. This can only be used for temporary pain relief and discomfort and cannot be reversed permanently. They don’t provide ways to align the bones, muscles or ligaments inside the foot.

Bunion toe spacers can be worn inside the shoes and are used between the big toe and the second toe. The crowding and rubbing of toes to each other can be prevented with the help of toe spacers.

Well-fitting shoes: People who have more risk factors such as genetics, should always follow precautions such as not using narrow high-heeled shoes. If the bunion is causing pain in the middle part of the foot, then try to wear flat shoes, shoes in which the toes can be cushioned or supported or walk barefoot as much as possible.

Physiotherapy for bunion: Some special exercises can be practiced to try to strengthen and stretch the foot muscles which may help in relieving pain due to bunion.

Painkillers: They include non-steroidal anti-inflammatory drugs such as tablets or an ointment. This will help in temporary relief of pain.

Injections: The steroid injection is used for swelling due to bunion, it is a late treatment just to avoid surgery. However, the direct injection to the joint can also be damaging if used too often or injected into the joint itself.

Surgery: If none of the non-operative procedures helped you in relieving the bunion pain then you can consider surgery. You should only consider it if it’s painful. Your physician will recommend a procedure called a bunionectomy if your bunion is troubling you in walking and daily activities. The surgery aims to relieve pain by realigning the bone, tendons, ligaments and nerves. This will help bring back the toe to the correct position. The full recovery period is around weeks to months but you will be able to walk even immediately on the same day after the surgery.

There are many surgical procedures available, and according to the severity, the treatment options might vary. It might be a single procedure or a combination. Every surgical bunion treatment will include:

How can you prevent bunions naturally?

You can prevent it by adopting some measures in day-to-day life such as :