Bunions

Bunions, or hallux valgus, occur when the big toe angles towards the other toes with a migration of the first metatarsal away from the second metatarsal. This deformity results in an apparent bump at the base of the big toe. Pain occurs as the bunion interacts with the shoe. In a shoeless society, there is no bunion pain! Treatment focuses on pain relief and adapting to  progression as bunions usually worsen over time.  

Causes:

Genetics: A family history of bunions can increase your risk.

Foot Type: Certain foot shapes or biomechanics can predispose individuals to bunions.

Tight or Poorly Fitting Shoes: Shoes that squeeze the toes or put pressure on the front of the foot can contribute to bunion development.

Arthritis: Conditions like rheumatoid arthritis can also contribute to bunions.

Symptoms:

Visible bump: at the base of the big toe.

Pain, swelling, or redness: over the bunion area.

Stiffness: in the big toe joint.

Difficulty walking: or finding comfortable shoes.

Calluses: may develop on the bump, between the toes as the 1^st and 2^nd toes interact (corns) and over the balls of the feet (Transferal Metatarsalgia)

Treatment:

Conservative Treatments:

Comfortable shoes: Choose shoes with a wide toe box and avoid high heels or pointed shoes. Also, modification of the shoes to accommodate the bunion can help. Using a “Ring and Ball Shoe Stretcher” (Amazon) can modify your shoe to fit your foot.

Padding: Bunion pads or toe spacers can help relieve pressure and reduce friction.

Medications: Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation.

Orthotics: Custom or over-the-counter orthotics can help support the foot and improve alignment.

Ice: Applying ice to the bunion area can help reduce swelling and pain.

Activity modification: Avoid activities that aggravate the bunion.

Surgical Treatment:

If conservative treatments fail to provide relief, surgery may be an option to realign the bones and correct the deformity.

Bunionectomy is a common surgical procedure that realigns the toe and removes the bony bump. There are two types of bunionectomies, osteotomy type (cutting bone to make a “crooked” 1^st Metatarsal) and Lapidus type (fusion of the first Metatarsal cuneiform joint).

When to Seek Medical Advice:

If you experience persistent pain, swelling, or difficulty walking.

If your bunion pain is affecting your daily activities.

If you have difficulty finding a shoe that fits properly.