Bunions are a deformity in the foot where the joints in the big toe are misaligned. The first big toe joint bulges out, away from the foot, and the second joint angles in towards the other toes. The joints can become sore and swollen, and make shoes fit improperly and uncomfortably.
The deformity causing a bunion is in the bone, an enlargement of the joint at the outside bottom of the big toe (the metatarsophalangeal joint). Bunions form when the toe moves out of place. The bump caused by the enlargement of the joint can rub uncomfortably against footwear, creating friction and pressure. Left untreated, the big toe’s movement angles in towards the other toes, and can sometimes overlap other toes (called Hallux Valgus). The movement causes the protuberance, or bump, to grow, which leads to increased irritation and inflammation. Sometimes, the big toe rotates, or twists, as it moves towards the second toe (known as Hallus Abducto Valgus). Bunions can also develop into other toe deformities like hammertoe.
The toe joint is always moving and flexing with every step, and the constant irritation, rubbing, and friction of bunions against footwear cause many people with bunions to suffer discomfort and pain, especially while walking, which increase as the bunion grows. The skin on the affected toe can become red and tender. Eventually, the deformity in the joint can lead to bursitis or arthritis. The skin on the bottom of the foot can thicken, and walking can become increasingly difficult. Untreated, bunions can lead to chronic pain.
Bunions are mainly caused by wearing shoes that are too tight. Although bunions are not strictly hereditary, they do seem to run in families, usually because of faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can all lead to bunion formation. 33% of people in Western countries are estimated to suffer from bunions.
Because bunions are bone deformities, they will not resolve on their own. The goals for bunion treatment are to relieve the pressure and pain caused by irritation, and to halt the growth of the enlargement. The most common methods to reduce pressure and alleviate pain include:
- Protective padding: Usually made from felt material, the padding can alleviate the inflammation and skin problems from the pressure and friction of the bunion against shoes.
- Remove corns and calluses: Removing corns and calluses on the foot can also reduce friction and pressure, helping shoes fit more appropriately, and alleviating some of the pain.
- Special footwear: Footwear designed specifically to accommodate the bunion without contributing to its growth can prevent it from getting worse, and can alleviate pain and pressure.
- Orthotic devices: Available both over-the-counter or custom made, orthoses can help to stabilize the affected toe joint, and keep the foot in a comfortable position for walking and standing.
- Exercise: Regular exercise of the affected area will help to maintain joint mobility and prevent stiffness or arthritis.
- Splints: Worn at night , splints can help realign the affected toes and joint. Adolescents suffering from bunions often benefit from this treatment, since their still-developing bones are more adaptable.