Treating Bunions

A bunion a bony ridge on the side of the big toe. It occurs when the bones in the big toe begin to lean toward the second toe. This movement forces the bones in the joint out of alignment. The “bump” at the base of the big toe is the top of the bone pushing against the skin.

Researchers estimate more than 28 percent of Americans have a bunion. 90 percent of patients are women. The condition can cause pain (especially when wearing certain types of shoes), burning, redness and swelling at the site of the bunion. The skin at the base of the toe may thicken. Continued movement can force the edge of the big toe over the second toe, causing corns or calluses and ingrown toenails.

Shoes are a major contributing factor in the development of bunions. Pointy, high-heeled or tight shoes put pressure at the front of the shoe and constrict the toes. The tendency to develop bunions runs in families. The condition is also more common in people with flat feet, low arches and arthritis.

Treatment for bunions falls into two categories –non-surgical and surgical. Non-surgical options aim to ease the pain of a bunion. The treatments can’t reverse the deformity, but may slow or inhibit further progression. One of the most important non-surgical treatments is changing shoe styles. Experts recommend shoes with a wide toe box and low heels. Those made with a soft upper material provide more “give” and put less pressure on a bunion. Stiffer upper materials can sometimes be “stretched” to provide more room for the toes.

Surgery should be chosen only as a last resort, usually when symptoms can’t be controlled with conservative measures, pain is severe or walking becomes very painful. There are several surgical techniques. Generally, the goal of surgery is to realign the bones, ligaments, tendons and nerves into their proper position. The bone in the toe joint is fractured and some of the bone may need to be removed. Recovery is typically long and may be associated with a significant amount of swelling, pain and stiffness. A larger bunion may take six to eight weeks of healing plus the extra months to fit into regular shoes.