Blog Post

Do you ever wonder what that bump on the side of your big toe is? That small “bump” is referred to as a bunion in the medical community. Bunions are defined as a bump on the metatarsophalangeal joint, also referred to as the MTP joint, located at the base of your big toe. Bunions occur when the bone or tissue at the big toe joint moves out of alignment. Your toe is then forced to bend toward your other toes, causing this painful bunion formation on the foot.

This joint is responsible for carrying most of your body weight when you are doing everyday activities- like walking, running, and other physical activity. A bunion is not something to be taken lightly. If untreated, they can cause extreme pain and interfere with the everyday activities you enjoy. The MPJ joint can become consistently sore and stiff. Many find it difficult or impossible to wear shoes. There are also cases of a bunion forming on the outside of the foot at the base of the little toe. This is referred to as a “bunionette” or “tailor’s bunion” and will also cause pain, soreness, and stiffness

What causes Bunions?

How do I end up with that bump? Bunions form when your normal balance of force on the joints and tendons of your feet become disrupted. Any disruption, no matter how small, can cause a bunion formation. This disruption can lead to instability in the joint, causing deformity. It takes years of abnormal movement and disruption to the joint at the base of the toe to cause this deformity.

• Inherited foot type: A bunion is a symptom of faulty foot development, meaning they usually start forming because of the way we walk, inherited foot type, or shoes. Bunions tend to run in families, because we even inherit foot types. It is the poor mechanics passed down to the next generation that can cause the bunion, rather than passing down a bunion.
• Foot injuries
• Neuromuscular disorders
• Congenital deformities
• Flat feet or low arches: Those who have flat feet or low arches are more likely to develop these issues.
• Arthritic patients: especially with inflammatory joint disease. Here’s more information about Arthritis.
• Wearing tight shoes: Even wearing that cute pair of shoes that may be too tight can cause the toes to be squeezed together, which means- yes ladies, you are at a higher risk for a bunion disorder compared to men.
• Work habits: There are even certain occupations that put undue stress on your feet that can contribute to a bunion formation.

What are the different symptoms?

How can you tell if you have a bunion? Only a podiatrist will be able to confirm if you have a bunion formation. However, there are symptoms of a bunion formation that you may notice.

• Development of a swelling, callus or firm bump on the outside edge of the foot, at the base of the big toe
• Redness, swelling, or pain at or near the MTP joint
• Development of hammertoes or calluses under the ball of the foot
• Corns or other irritations caused by the overlap of the first and second toes
• Restricted or painful motion of the big or small toe

Diagnosis and treatments

Treating a Bunion at home

• Non-medicated bunion pad: Often, patients find some relief using a non-medicated bunion pad around the bony prominence of their foot.
• Toe spacer: There are also some who find relief using a toe spacer, which separates the big toe and second digit.
• Wide shoes: Shoes with a wide and deep toe box are helpful and highly recommended by podiatrists.
• Ice packs: If you experience any inflammation and pain, applying ice packs to the formation a few times a day can reduce swelling.
• Avoid high-heels: Ladies, avoiding high-heeled shoes over two inches tall will provide some relief.
  When to visit a Podiatrist?

If the formation becomes untreatable, you should be seeking a podiatrist’s attention. However, identifying a bunion early in development is important if you want to avoid surgery. The main goal of early treatment is to relieve the pressure on the bunion and stop any further progression of the deformity. Bunions will become larger and painful if untreated, making it more difficult to treat non-surgically.

What can a podiatrist do to help?

A podiatrist may recommend many different options depending on the severity of the formation.

• Using padding and tape to minimize pain and keep the foot in a normal position, reducing pain and stress on foot which may lead to further bunion development
• Anti-inflammatory drugs and cortisone injections to ease the pain, discomfort, and inflammation
• Physical therapy may be prescribed to provide relief to the inflammation and pain.
• Ultrasound therapy which is becoming more popular in treating bunion formations and soft tissue involvement.
• Orthotics to control foot function and reduce symptoms, discomfort, and further deformity.

Bunionectomy, the Bunion surgery

Surgical options when treating a bunion formation are used when early interventional treatments fail or the deformity progresses too far for more conservative options. Podiatric surgery can become necessary to repair and relieve the pressure of the toe joint.

There are many surgical options available, and your podiatrist will discuss these with you. Surgery will remove the bony prominence and realign the toe joint to it’s normal position. This surgery is called a simple bunionectomy, which means “removal of bunion”. This option can be used for less severe formations.

More severe formations can require a more complex procedure where cutting the bone and realigning the joint is involved. The recovery time for this procedure is several weeks and some swelling and discomfort is to be expected. Pain is managed through the use of medications prescribed by a podiatrist. Closely following all postoperative instructions discussed between you and your podiatrist plays a very crucial role in your recovery.

How can you prevent Bunions?

• Avoiding shoes with a narrow toe box
• Wearing supportive shoes
• Custom orthotic inserts

It is important to see your podiatrist when you notice the first signs or symptoms of a bunion since early treatment can stop or slow any further deformity.