A “bunion” refers to a bump along the inside of your foot at the base of the big toe. It occurs when the first metatarsal bone drifts medially and the big toe drifts laterally (toward your pinky toe). It is often painful and achy due to the pressure from shoes on the growing bump. Sometimes there can be excess bone in or around the joint space (arthritis) as well . Pain can be constant or intermittent. Bunions can also range in severity from mild to moderate to severe. A mild bunion may only cause occasional discomfort and conservative treatment will be successful. But a severe bunion comes with significant deviation of the big toe causing intense pain and deformity, relieved sometimes only by corrective surgery.
BioPed clinicians are here to help you treat your bunions and relieve pain.
What causes a bunion?
There are a number of reasons why people develop bunions, but genetics and mechanics are the most common inciting factors. A bunion may be present on one or both feet depending on the factors that create it. Let’s explore the most common causes;
Genetics – One cause of bunion formation is genetics. It is a hereditary condition that runs in families, though it may skip a generation. If a grandparent or parent has bunions, it is probable that you or a sibling will develop them at some point in your life.
Arthritis – Arthritis is a comorbidity often found with bunions, particularly rheumatoid arthritis as it deforms the joint capsule allowing for joint deviation +/- increased bone growth. Arthritis in its other forms wears down the joint and so the body, to protect itself, causes new bone to grow in and/or around that space.
Biomechanics – Another common cause is faulty biomechanics. With a sometimes tight calf muscle and ultimately, prolonged pronation (more time spent rolling inwards) through gait there is increased pressure on the big toe joint at the ball of the foot, inciting angulation.
What are the most common signs and symptoms of a bunion?
- Visible bump at the base of the big toe
- Hallux Valgus deformity (big toe crowding or pointing towards the second toe)
- Joint redness and tenderness, especially with shoe wear
- Persistent ache at the base of the big toe
- Sharp pain while weight bearing
Surgery may be required if pain and discomfort is severe and negatively impacts activities of daily living. It is also a more permanent solution for those who have developed a chronic wound from their crossover toes.
How to treat a bunion?
Many solutions exist to help relieve pain of the bunion and prevent the condition from progressing. There is no reversing/ corrective action you can take with a bunion unless you choose surgery, and the results of that route differ from patient to patient.
Toe Spacers
Silicone toe spacers that insert between the big toe and the second toe help to create space between them and also serves to re-align the big toe joint, relieving pressure on the bunion bump if the deformity is still flexible.
This is an option in the early stages of bunion formation.
Daytime alignersÂ
There are a variety of bunion socks and aligners that slip over the foot to help realign the big toe and relieve pressure on the bunion bump, through cushioning of the area and compression or pulling of the toe back into alignment. These can be used during the early to moderate stages of bunion formation, both as relief and prevention.
Night splintsÂ
These splints are made of a rigid material with straps to secure them to the foot to realign the big toe and relieve pressure on the bunion. The night splint is non-walkable as it holds the toe in a rigid position and is not meant for weight bearing. These can be used in more advanced stages of bunion formation.
Orthopedic shoes
Ensuring your shoe has a wide toe box to accommodate the bunion, without placing more pressure on the joint, is essential to relieving pain. Orthopedic shoes can come in a variety of widths to make finding the right fit easier. They can also come with a forefoot rocker sole, which propels you through the toe off phase, off-loading the ball of the foot and decreasing pressure in the bunion area. Other footwear modifications, such as spot stretching, balloon patches and split soles are also an option if required.
Custom-made orthotics
Orthotics can help to manipulate the biomechanics of the foot to offload the painful bunion area throughout gait. By customizing them to your foot structure and mechanics we can take pressure off the bunion and big toe to prevent those mechanics from causing the bunion to progress. Biomechanics, such as prolonged pronation (rolling inward) and medial toe off (pushing off on the inside of the big toe) are the most common mechanics connected to bunion formation. Cushioning or excavation (creating space) under the painful area are also courses of treatment for further comfort.
Surgery
When the bunion has progressed to the point of severe foot deformity and no other options can mitigate or relieve pain, corrective surgery is the last option. Orthopedic surgeons perform this surgery, though the results and effectiveness vary case by case. This should be discussed with your doctor.
BioPed Footcare Clinicians can help you navigate the various modalities and treatment options for bunions. Through assessment and gait analysis we can pinpoint what factors are affecting the joint and bunion growth and recommend the best course of treatment for your bunion stage and symptoms. Find your local BioPed clinic to book an assessment and let us help you relieve bunion pain today.
