What to do About Bunions

Houston Foot and Ankle Surgery

Painful bunions interfere with walking and exercising. You can prevent them from getting worse.

Many women have a bunion — a deformity of the metatarsophalangeal (MTP) joint at the base of the big toe. A bunion develops when the first metatarsal bone of the foot turns outward and the big toe points inward (toward the other toes), causing the joint to jut out. The Latin name for the deformity is hallux valgus (hallux means big toe, and valgus means turned away from the midline of the body). Most shoes don't accommodate the resulting protrusion and so put pressure on the misaligned joint. Eventually, the bursa (a fluid-filled sac that surrounds and cushions the joint) becomes inflamed, and the entire joint becomes stiff and painful.

Why bunions need attention
The MTP joint helps us bear and distribute weight during a range of activities. A bunion at this critical junction of bones, tendons, and ligaments can seriously impair the foot's functioning. For one thing, a bunion on the big toe can damage the other toes. Under the pressure of the big toe, they may develop corns or become bent, forming hammertoes. The nails may become ingrown, and calluses may form on the bottom of the foot. If you constantly shift your weight off the painful big toe joint to other metatarsals, you may develop discomfort in the ball of the foot. As the misshapen joint becomes more uncomfortable and harder to fit into shoes, you may have to curtail exercise and other activities. Even walking may become difficult.

Especially in older women, foot disorders are a major cause of disability and sedentary habits. A study involving almost 3,000 women and men ages 56 and older found that women are more likely to have bunions as they get older, and the more severe their bunions are, the lower their quality of life is. You should seek treatment if the pain and deformity interfere with daily routines and physical activity.

Conservative treatment
The first step is to relieve the pressure by wearing the right kind of shoe. (It's also important to maintain a normal weight.) Shoes should have a wide, flexible sole to support the foot and enough room in the toe box (the part surrounding the front of the foot) to accommodate the bunion. Some good choices are sandals, athletic shoes, and shoes made from soft leather. Shoes with a back should have a sturdy heel counter (the part surrounding the heel) to keep the heel of the foot snugly in place. You may be able to reshape narrow shoes with stretchers that make room in the toe box for the bunion. Keep heels low (no higher than an inch).

You can also protect the bunion with a moleskin or gel-filled pad, available at drugstores. (Make sure your shoes have enough space to accommodate it.) A clinician may recommend semisoft orthoses (shoe inserts) to help position the foot correctly as it strikes the ground. You can also wear a splint at night to hold the toe straight and ease discomfort.

When the bunion is irritated and painful, warm soaks, ice packs, and nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help. Whirlpool, ultrasound, and massage may also provide some relief. Cortisone injections can relieve pain temporarily by reducing inflammation, but they have many side effects, especially when used often and at high doses.


Source: Health.Harvard

RIVERA FOOT & ANKLE: At Orlando H.Rivera DPM, our priority is to deliver quality care to informed patients in a comfortable and convenient setting. When you have problems with your feet, you need to turn to a podiatrist who listens and responds… an experienced doctor who knows the field and can effectively diagnose and treat your needs… a friendly physician who counsels you on the best ways to maintain and improve your health. Our physician(s) meet all these criteria. Plus, you benefit from a dedicated team of trained professionals who give you the individualized attention you deserve.

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