Bunions

What Is a Bunion?

A bunion, scientifically known as hallux vulgus, is a painful protrusion that develops at the metatarsophalangeal joint (MTP) located at the inner base of the big toe. Bunions are slow-developing, but it’s crucial to address them as early as possible before they become worse and compromise the long-term health of the foot.

What Are the Common Causes of Bunions?

The slow evolution of a bunion can allow it to go undetected for years, which makes dealing with one before it becomes problematic a real challenge. Bunions often result from poor genetics, but other factors like improper shoewear can exacerbate the symptoms. 

A bunion occurs when the bones, tendons, and ligaments in the front of the foot shift out of their normal alignment. When the foot structure is misaligned, the big toe is susceptible to being pulled toward the outside of the foot, causing the MTP joint at its base to protrude. Because this joint is involved in every step the foot takes, this protrusion is prone to constant irritation. 

An irregular foot structure may not cause considerable a bunion on its own; However, wearing narrow or tight shoewear can put additional stress on the joint region, heightening the risk that one might develop. Long periods of standing won’t cause a bunion on its own but could exacerbate symptoms. 

What Are the Signs and Symptoms of a Bunion?

The primary sign of a bunion is the bony bump inside the foot near the big toe’s base. When left untreated, these bumps will continue to grow over time, becoming a more painful nuisance.

Those suffering from a bunion typically experience pain and soreness in the region, and the affected skin will likely become red. Discomfort may start as intermittent before becoming more consistent, especially when walking or running.

Symptoms may also include swelling of the big toe and irritation in the other toes from being smushed together. Calluses can also develop from the excess friction. In severe cases, the big toe could begin to force itself on top of or beneath the second toe, causing that toe to bend out of place. 

Narrow shoewear will make pain more noticeable, but a large enough protrusion will make any shoewear uncomfortable. Discomfort may also lead to an abnormal weight distribution when walking, which puts extra stress on other areas of the foot. At some point, all forms of mobility may become difficult. 

Bunion-like symptoms can also occur on the outside of the foot, impacting the small toe. This condition is called a bunionette.

What Are the Risk Factors?

Anyone can develop a bunion, but poorly fitted footwear and underlying predisposed conditions like exceptionally flat feet heighten the risk. There is also a common link to at least one parent suffering from the medical condition.

Because narrow shoes are one of the most significant factors beyond genetics, women are at a greater risk of dealing with a bunion. While the condition can occur in children, the structural shift of the foot is often undetectable until adulthood. 

People dealing with inflammation-related conditions like Rheumatoid arthritis are also at a higher risk of experiencing a bunion. 

What are the Preventative Methods to Avoid a Bunion?

While some bunions are unavoidable, proper foot health can reduce your chances of dealing with one. Avoiding pointed toes, allowing enough space between the big toe and the shoe’s end, and wearing soft soles are all steps to optimize foot health. 

When measuring for new shoes, sit, stand, walk, and jog to ensure the toes have plenty of space. Feet are also at their biggest near the end of the day, so this is the best time to try new footwear. 

How Is a Bunion Treated?

Non-surgical

Bunions are irreversible, so the primary treatment goals are pain reduction and halting the condition from worsening.

For low-pain bunions, non-steroidal anti-inflammatory drugs (NSAIDs) and footwear modification are two immediate responses that should alleviate the condition. If inflammation is minor, applying ice a few times daily and temporarily modifying activities are other recommended measures.

If symptoms persist or worsen, consult your doctor, who may want to schedule an exam. During the exam, your doctor will evaluate the toe region and ask you to perform various movements.

X-rays will provide insight into your foot health, including the alignment of the MTP joint. Based on the level of misalignment, the doctor will determine the proper course of action.

A cortisone injection can help to reduce inflammation, and a toe splint or medical tape may assist in keeping the toes aligned. Your doctor might also suggest shoes with a wider toe box or adding shoe inserts known as orthotics to provide additional cushion.

Surgical

If pain persists after addressing improper shoewear and exploring alternative treatment options, surgery may be a necessary intervention. The surgical technique will depend on the severity of your foot condition, as well as your activity level and age.

The primary focus of surgery is to reduce pain and improve functionality. The procedure will aim to realign the foot, including the bone, tendons, and ligaments, to accomplish these goals.

The majority of bunion procedures are outpatient. Surgeries for mild to moderate cases will focus on removing the enlarged portion of the bone, while more severe cases may require the surgeon to cut the bone to shift it back to the proper position.

Overall, the outlook on bunion surgical procedures is good. Recovery time will likely be a minimum of several months and will vary depending on the procedure’s invasiveness. Post-op rest will be a priority, and therapy will aid in re-strengthening the foot. The best way to avoid post-surgery complications is to abstain from wearing tight-fitting shoes and choose footwear that gives adequate support.

To learn more about bunion treatment options in the Fort Myers area, contact the Institute for Orthopaedic Surgery and Sports Medicine.