Overview

A bunion, medically termed hallux valgus, occurs when the big toe leans too far into the second one and causes a swelling on the side of the big toe joint. Forming on the base of metatarsophalangeal joint (MTP) of your big toe, a bunion is a bony bump that forces your big toe to grow abnormally big and stick out.

Symptoms

Bunions can be various sizes and some aren’t even particularly painful. However, it is possible for the big toe to put pressure on the second toe, causing what is known as a hammer toe. It is also possible for the first two toes to cross over, resulting in difficulty in walking.

Other than the noticeable bony bump on the base on the outside of your big toe, other symptoms of bunions include:

  • Soreness or redness surrounding the big toe joint.
  • Swelling around the big toe joint.
  • Restricted and limited movement of the big toe.
  • Pain, which can be intermittent.
  • Calluses and corns, which may develop when the first and second toe overlap.
  • Skin thickening around the big toe joint.

Causes

Bunions generally occur when the big toe leans too far over into the second toe. The area swells and as shoes begin to rub against it, and inflammation and pain results. Bunions tend to be genetic, therefore many people who suffer from the condition have a family history already.

Individuals who are prone to bunions should never wear tight footwear. It’s this factor that results in the condition being far more of an issue for females than males. Pointed-toe, tight, and high-heeled shoes are not the primary cause of bunions, however, they can be a contributing factor.

Other causes of bunions include muscle imbalances and foot injuries. Arthritis, especially inflammatory types, such as rheumatoid arthritis, may also be a causal factor in developing bunions.

Diagnosis

A Pensacola foot and ankle specialist can identify a bunion by a physical examination. This physical examination may reveal a bony bump, redness, swelling, and limited range of motion, which are hallmark signs of bunions. An X-ray will show the extent of the bunion and whether there is any associated arthritis in the affected area.

Treatment

Treatment options for bunions including conservative non-surgical treatments and surgery.

Non-surgical treatment

As many as 50 percent of all bunion sufferers do not require surgery. Non-surgical treatments aim to prevent the development of ulcers and pressure sores, as well as relieve pressure on the foot.

In many cases, purchasing new, well-fitting and comfortable shoes alleviates pain. A Pensacola orthopedic specialist can also prescribe an orthotic. This is a device inserted within footwear, which can prevent the condition from deteriorating.

Other non-surgical treatments include ice, rest, steroid injections, and medications, as well as taping, padding, and/or splinting.

Surgical treatment

For some, surgery is the only way to correct their bunions and restore proper function to the big toe. Surgical procedures for bunions correction may include:

  • Removals of swollen tissue surrounding the big toe joint.
  • Removal of part of the bone to straighten the big toe.
  • Straightening of the abnormal angle of the big toe.
  • Joining of the bones of the affected joint.

For many years, bunion surgery had the reputation of being incredibly painful. Nowadays, however, modern surgery is far less invasive and more sophisticated. Each patient undergoing bunion surgery is assessed on their lifestyle as well as on the extent of the deformity of their bunion.

The best approach in terms of outcome, therefore, is to have a multi-disciplinary team of specialists working in tandem in order to achieve positive and lasting results.

Frequently Asked Questions

Q: Will walking make bunions worse?

Since you carry most of your weight and your joint flexes while you walk with every step, walking becomes difficult and painful when you have a bunion. This worsens the bigger your bunion is.

Q: What type of shoes cause bunions?

Narrow, pointed or tight shoes can cause bunions. Avoid high heels, especially those that have heels higher than two inches. These types of shoes also put you at risk of forming bunions. Tight footwear can contribute to the swelling and pain of bunions. Those complaining of bunions, tend to be those wearing closed shoes.

Q: When to have bunions removed?

If your bunion is causing you pain or is disabling you and you've already tried conservative treatments with no luck, you may need surgery. Your orthopedic surgeon may perform a bunionectomy if your bunions are mild. This is where your North Florida Bone & Joint Specialists - Ankle and Foot Center orthopedic surgeon shaves off any extra bone from your first metatarsal bone on its outside. They then realign your tendons, ligaments and muscles of your big toe.

If you have a moderately deformed bunion, your surgeon will likely cut your bone that's near your metatarsal head in order to place it into the correct position. Pins and screws will hold your bone in place while you're healing.

If your bunions are severe, your surgeon cuts the extra bone of the first metatarsal head away as well as the bone at your first wedge-shaped metatarsal base.

Q: Which kind of doctor treats bunions?

You may be seen by a podiatrist who practices podiatric medicine. They specialize in diagnosing and treating ankle and foot problems, including bunions. However, you may need to see an orthopedic specialist or surgeon, depending on the severity of your bunion.

Q: Can bunions be prevented?

To prevent bunions, being proactive is key. Learn your risk factors and if you have any mechanic issues with your feet.

Your podiatrist will analyze your foot, the wear pattern of your shoes and your stride if you're unsure if you have an issue. They'll then provide you with an honest evaluation.

Be sure you're making the right shoe choices. Women shouldn't wear footwear with high heels as much as possible. Ensure your shoes have a deep, wide toe box. Shoes shouldn't crowd or squish your toes. Purchase shoes that have rocker soles which will take the pressure off the area where your bunion is.

Regularly check your feet. Look for any swelling, redness or discoloration. Check for stiffness by flexing your toes. Call us if you notice any of these signs if they persist for several days.

Q: Who gets bunions?

Women commonly get bunions. People who wear shoes that are closed get bunions more than those who are barefoot. Arthritic diseases like RA and abnormal bone formation of your foot at birth are both risk factors. People who perform ballet tend to get bunions often.

Q: Can bunions get infected?

Bunions may cause sores and blisters due to them rubbing against your shoe on the inside. If you don't have these wounds treated, they can become infected and even lead to life-threatening complications.

Q: Can a bunion go away on its own?

If you notice a bunion and treat it early, you can slow the deformity down or even stop it. Cold packs, rest and other palliative self-treatments are good. Large pharmacies or orthopedic shoe stores sell silicone bunion shields. While they don't correct the issue, they do relieve pain from bunions.