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What are bunions?

When people think of bunions, they typically think of a large "bump" on the inside of the foot behind the big toe. However, a classic "bunion" is a deformity of the entire first ray of the foot— or the top of the big toe to the end of the first metatarsal bone in the foot.

Bunions are formed when the big toe is forced to bend towards the others instead of pointing straight ahead. Over time, this can throw the bones out of alignment and produce a painful lump of bone known as a bunion.

What causes bunions?

“A bunion is a structural deformity that results from many biomechanical factors,” says Graham Bahnson, DPM, a podiatrist at Piedmont.  “A bunion may be caused by a high degree of laxity or hypermobility within the foot as well as various forms of arthritis.”

Bunions can also be caused by foot injuries, congenital deformities, or mild variations in the lengths of the legs.

Bunions commonly run in families, because the shape and structure of the foot are hereditary. People who have low arches, flat feet or loose joints are more susceptible to getting bunions.

Certain shoes can also trigger the formation of bunions. High heels or other shoes that are too tight can exacerbate the problem, because they squeeze the toes together and force them to the front of the shoe.

How are bunions treated?

Many conditions can mimic a bunion including a painful bursitis, rheumatoid arthritis, or gout. If your foot pain is intense or interferes with daily activities, it’s important to schedule an appointment with your doctor to determine the cause. If a bunion is discovered, your doctor can discuss treatment options.

“Thankfully, not every patient needs surgery,” says Dr. Bahnson.  “We usually try to manage each patient's symptoms conservatively before we have that discussion.”

Conservative treatment includes:

  • Wearing shoes with a wide sole to give feet more room.
  • Taping your toes or padding the bunion to minimize pain.
  • Icing your feet to relieve soreness and inflammation.
  • Taking ibuprofen or naproxen for pain management.
  • Massaging the feet or using a whirlpool to reduce pain.

If the conservative approach doesn’t work, surgery may be the best option.

“Believe it or not, there are actually more than 100 different surgical procedures to correct a bunion deformity,” says Dr. Bahnson. “The severity and specific biomechanics of each patient dictate which procedure is chosen.”

The most common procedure involves realignment of the big toe joint. In this procedure, the surgeon will cut the big toe joint and realign it to a normal position.

“The recovery time can range from almost immediate walking in a surgical shoe to the need for non-weight bearing in a cast or boot with crutches for six to eight weeks,” says Dr. Bahnson.

Tips to prevent bunions

Bunions can be painful. To prevent them or to slow their progression:

  • Wear supportive shoes.

“Most of us are actually walking around in very poor shoes,” says Dr. Bahnson. “This tends to be more of an issue for women.  I recommend patients wear shoes with a stiff, supportive sole and a functional insert as much as possible. The insole can provide balance to the foot and prevent structural compensation between the hindfoot and the forefoot which can ultimately slow or prevent the progression of both bunions as well as hammertoes and other deformities down the road.”

  • Consult your doctor if you are in pain.

“I typically recommend for people to see a podiatrist when the condition becomes painful or begins to interfere with wearing shoes or daily activities,” says Dr. Bahnson.

  • Stay active and maintain good health.

“Stretching and maintaining an otherwise healthy weight and lifestyle can also help to slow the progression of a bunion over time,” says Dr. Bahnson.  “I had an attending in residency once who would make the following comment to patients, ‘If you treat your body well, it will serve you for many years and miles to come!’"

For more helpful, healthful tips, click here

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