Why do they hurt so bad?
What do you think of when you hear the word “bunion?” If you’re like most people, you probably think of your grandparents or other elderly individuals complaining about their bunions hurting. Is it something that only affects older people? What exactly is it? How is it treated? Is it preventable?
Definition
Bunions are bony bumps that occur at the joint of the base of your big toe. It’s the result of something causing the bones in the front part of your foot to move out of place. This makes the tip of your big toe get pulled toward the smaller toes, forcing the joint at the base of your big toe to stick out. While the exact reason this occurs is unknown, there are several theories about why it happens. It’s thought to be from an inherited foot type, foot stress/injuries, or deformities present at birth. It’s also believed to be associated with arthritis, especially inflammatory types, like rheumatoid arthritis. Experts aren’t sure if wearing tight, high-heeled, or too-narrow shoes cause bunions or just makes them worse. Smaller bunions (bunionettes) can develop on the joint at the base of your little toe.
Bunion symptoms can include a bulging bump on the outside of the base of your big toe, swelling/redness/soreness around your big toe joint, corns/calluses (often develop where the first and second toes rub against each other), ongoing pain, pain that comes and goes, and limited movement of your big toe. Most of the time, bunions don’t require treatment. However, you should see a doctor if you have ongoing big toe/foot pain, a visible bump on your big toe joint, decreased movement of your big toe/foot, or difficulty finding shoes that fit correctly because of a bunion.
Several things can increase your risk of developing bunions. Wearing high heels is one because they force your toes into the front of your shoes, often crowding your toes. If you wear ill-fitting shoes (ex. too tight, too narrow, or too pointed), you’re more likely to develop bunions. If you have rheumatoid arthritis, your chances are higher. Also, having a family history of bunions means you’re at an elevated risk of having them. Bunions have three main complications: bursitis, hammertoe, and metatarsalgia. Bursitis is a painful condition that occurs when the small fluid-filled pads that cushion the bones near your joints become inflamed. Hammertoe is an abnormal bend that occurs in the middle joint of a toe, usually the toe next to your big toe. It results in pain and pressure. Metatarsalgia is a condition that causes pain and swelling in the ball of your foot.
Treatment
Bunion treatment depends on its severity and how much pain it’s causing. The initial step is nonsurgical options. The most important thing to try is wearing roomy, comfortable shoes that provide plenty of space for your toes. You can also buy over-the-counter, nonmedicated bunion pads or cushions. These act as a buffer between your foot and your shoe. Another alternative is padded shoe inserts because they distribute pressure evenly when you move your feet, reducing your symptoms and preventing your bunion from getting worse. It’s important to note that over-the-counter supports provide relief for some people. However, others require prescription orthotic devices. Applying ice to your bunion after you’ve been on your feet too long or if it becomes inflamed can help relieve soreness and swelling. To help control any pain, you can try medications like acetaminophen, ibuprofen, or naproxen sodium. Some individuals find that cortisone injections in the area help.
If conservative treatment doesn’t relieve your symptoms, your doctor might suggest surgery. Remember that surgery isn’t done for cosmetic reasons, only when a bunion causes frequent pain or interferes with your daily activities. There are many surgical procedures available for bunions, so your doctor will help you decide which is the best for you. Depending on the procedure, it can be done as a single method or in combination. They might involve removing the swollen tissue from around your big toe joint, straightening your big toe by removing part of the bone, realigning one or more bones in the forefoot to a more normal position to correct the abnormal angle in your big toe joint, or joining the bones of your affected joint permanently. While you may be able to walk on your foot right after a bunion procedure, full recovery can take weeks to months. It’s essential to realize that to prevent a recurrence, you’ll need to wear proper shoes after recovery. This means it’s unrealistic to expect to wear narrower shoes after surgery.
Prevention
The best way to try to prevent bunions is to wear comfortable shoes. This means choosing them carefully. To provide the best fit, your shoes should have a wide enough toe box that your toes aren’t crowded. Also, there should be space between the tip of your longest toe and the end of the shoe. Your shoes should conform to your feet but not squeeze or press on any part of your foot, making it uncomfortable.
While bunions can be painful, many treatment options are available to make you more comfortable. If you have any questions or concerns about bunions, please speak with your doctor. If you would like more information, please visit OrthoInfo’s bunions page at https://orthoinfo.aaos.org/en/diseases–conditions/bunions/