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 Varus ). 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 hammertoe .
Many people 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.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet , and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- 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.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
Surgical treatment of bunions is nearly never considered in our foot clinic. I can count on one hand the number of patients we have referred for surgery of bunions in the last 35 years. My foot clinic practices conservative foot care which means that we avoid surgery and medications (drugs) when ever possible as there is no surgical treatment or drug which does not have side effects, in some cases life threatening. Most surgeries to bunions are performed for cosmetic reasons only and this is a huge mistake. Never elect to undergoe surgury on any joint that is pain-free as you may be setting yourself up for a future of regret. Thereare many options for the treatment of bunions which make sense and do no involve surgery.
If you or a loved one would like to 'get well' naturally, please do hesitate to contact the knowledgeable Foot Specialists / Chiropodists at our Toronto foot clinic, Academy Foot and Orthotic Clinics.
Dr. John A. Hardy personally received permission from Dr. Larry Huppin to place his video on my website after I told him that we shared the same philosophy when it comes to the non-surgical treatment of bunions.