Bunions | How to Treat Bunions | Prevention | West Idaho Orthopedics
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Bunion Prevention & Treatment

A bunion is a bony protuberance that develops at the base of the big toe joint. Pressure on the joint causes the big toe to lean into the second toe. This gradually changes the normal structure of the bone joint, resulting in the bunion hump. Bunions typically worsen over time, causing painful symptoms which can make walking and wearing shoes uncomfortable.
Wearing ill-fitting shoes

Tight, high-heeled, and too-narrow shoes force the foot bones into an unnatural position, contributing to bunion development.

Heredity

Bunions may develop because of inherited structural foot defects. Foot type is hereditary and some types are more predisposed to bunions than others, such as flat feet, low arches, and loose joints and tendons.

Arthritis

People with inflammatory conditions, such as rheumatoid arthritis, are more susceptible to bunions because of weakened ligaments and joint capsules.

Additionally, people in occupations which involve a lot of standing and walking are prone to developing bunions.

The most prominent symptom of a bunion is a bony knob at the base of the big toe, with the toe pointing inward. Other symptoms include:

  • Swelling and redness around the big toe joint
  • Persistent or intermittent pain and tenderness
  • A burning nerve-like sensation on the bump
  • The development of corns or calluses on the bump
  • Stiffness and restrictive movement of the big toe which may make walking difficult

Bunions can affect anyone, but they are 10 times more common in women than in men. Women tend to wear tight and narrow shoes, such as high heels. When walking in high heels, the body’s weight is shifted forward, putting pressure on the big toe.

Athletes, such as soccer players, runners, and particularly ballet dancers, whose feet endure repeated stress are at an increased risk of developing bunions. Athletes who over-pronate are especially prone to bunions because they put too much stress on the joints during the push-off phase of running.

A doctor can identify a bunion by physically examining your foot. Though your doctor can diagnose your bunion based on the physical appearance of your toe and symptoms, he or she will order an x-ray to find the cause and severity. The x-ray will show how far out of alignment the bones have become.

Treatment will depend on the severity of the bunion. In many cases, pain can be managed through nonsurgical treatments. These treatments include:

  • Changing shoes. For many, bunion pain can be successfully managed by switching to comfortable shoes that offer enough space for your toes. Select shoes with wide insteps, broad toes, and soft soles. Popular brands include Altra, Topo, Birkenstock, and Alegria.
  • Padding. Over-the-counter bunion pads can be useful, as long as they don’t put pressure on other areas of the foot.
  • Shoe inserts. Over-the-counter arch supports or prescription orthotics help to distribute pressure evenly as you move your feet. This can reduce symptoms and keep your bunion from getting worse.
  • Icing. Applying ice several times a day can help reduce soreness and inflammation.
  • Medication. Nonsteroidal anti-inflammatory medications can help relieve pain and inflammation.

If your bunion restricts your daily activities and conservative treatments fail, surgery may be the best option. Most often the surgeon will realign the bone behind the big toe by cutting the ligaments at the joint. In more severe cases, some of the bone may need to be removed and set in place with screws.

There are some potential complications after surgery, which include:

  • A delay or failure of the bone to heal, or healing in the wrong position.
  • Damage to the nerves in your foot.
  • Thickened scar tissue.
  • Prolonged pain and swelling.
  • Stiffness in your toe joint.

Recovery from surgery typically takes 6 weeks to 6 months. Following surgery, you will need to wear a cast or surgical boot to protect your foot. You will also need to avoid getting your stitches wet. You will not be able to bear weight on your foot for the first few weeks until the wounds heal, and you will require the assistance of crutches, a walker, or a knee scooter. Keep off your feet as much a possible, and use elevation to reduce recovery time and inflammation. Bunion correction surgery is very successful. You must take great care following surgery to ensure that your foot heals correctly.

Bunions typically get worse over time. If left untreated, conditions such as arthritis can develop due to long-term damage sustained by the joint in the big toe. An untreated bunion can also lead to deterioration of the cartilage in the joint as well as crossover toe, where the second toe sits on top of your big toe. Bunions can be cured through surgery, however, arthritis and chronic pain cannot be cured. Therefore, leaving a bunion untreated can potentially have a big impact on your quality of life.

Recurrence of a surgically corrected bunion has been reported in as many as 16% of cases. This often occurs when the bony protuberance is shaved off but the underlying deformity is not corrected. Fortunately, there are several ways to help prevent a bunion recurrence. Wearing a soft splint at night can prevent shifting of the re-aligned toe. Custom orthotics are also beneficial as they are designed to keep the foot joints in alignment, providing stability to the big toe joint. Finally, wearing supportive shoes will reduce the risk of recurrence. If you must wear high heels, do so in moderation.

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