Bunions – Symptoms, Causes, Treatments, Surgery and Recovery
Bunions are a widespread ailment often caused by wearing tight or narrow shoes or simply as a result of an inherited structural defect in the foot. Also known as Hallux Valgus, a bunion is a bony bump formed at the base of the big toe on the inside of the foot. They can cause significant pain and should be treated to prevent problematic side effects. Read on to understand:
What is a Bunion?
A bunion is a deformity of the foot at the metatarsophalangeal joint, which is the joint that connects the big toe to the foot. This joint, also known as the MTP Joint or “big toe joint,” helps distribute body weight on the foot while walking, running, or standing. A bunion is formed when the foot bones are pushed into an unnatural shape. Over time, the big toe deviates toward the other toes and the base of the big toe protrudes. This is known as the hallux valgus deformity. Excess pressure on this joint causes enlargement on the inside of the foot at the base of the big toe.
While bunions most commonly affect the base of the big toe on the inside of the foot, they can also affect the outside of foot. These smaller bunions are known as a bunionette or tailor’s bunion. While small bunions are painless, those that result in pain, especially when walking, can be associated with other symptoms such as swelling of the soft tissue at the base of the big toe along with redness and tenderness in the area. Rest often relieves the pain, but development of arthritis in severe bunions can lead to chronic pain in the big toe joint.
A bunion is diagnosed after consideration of the anatomy of the foot, including joint and foot function. X-rays can be helpful in determining the severity of the bunion and to screen for more severe conditions such as arthritis or gout. X-rays are an excellent method to see the alignment of the toes in a standing position.
• Your big toe points toward your second toe, or your second toe overlaps your big toe
• A prominent bump on the inside of the MTP or big toe joint
• Pain on the inside of your foot at the big toe joint when wearing any kind of shoe
• Pain each time the big toe flexes when walking
• Redness, swelling , or thickening of the skin on the inside of the big toe joint
Typical Causes of Bunions
Bunions are a widespread foot ailment that can be caused by a number of factors including genetics, excess weight gain, activity level, and ill-fitting shoes. Other less common causes of bunions include trauma to the MTP joint (sprains, fractures, and nerve injuries), neuromuscular disorders, and limb-length discrepancies. Some studies report that bunions tend to occur ten times more frequently in women than in men, primarily as the result of wearing narrow, pointy, tight fitting, and/or high-heeled shoes over a significant period of time. Repetitive stresses to the foot can also cause bunions.
Treatments for a Bunion
Alternative and Non Surgical Methods
Change your footwear! Relief from bunion pain can be as simple as changing the type of shoes you wear. Overall, wearing shoes that give the foot and toes ample room to move is the simplest way to prevent discomfort from bunions. Ample space for the toes will prevent the big toe from being overcrowded, and ultimately pushing against the smaller toes.
Tips for proper shoe fit:
• Size varies among brands, so be sure to judge the shoe by how it fits on your foot rather that the size marked on the shoe
• Find a shoe that is similar to the shape of your foot.
• Measure your feet regularly. The size of your feet tend to change as you grow older.
• Be sure to stand during the fitting process.
• Make sure you can extend all of your toes and that there is adequate space for your longest toe.
• Walk in the shoe to make sure it feels right.
Shoes can also be stretched to relieve bunion discomfort. Bunion pads made from silicone can be used to line the area that presses against the bunion, relieving pain and preventing further deformity.
If discomfort is still prevalent, consider visiting an orthopedist who can provide custom-made insole orthotics. Orthotics will ensure proper alignment of the foot and will reduce pressure on the bunion.
Taping your bunion can also reduce the amount of pressure on the inflamed joint. Likewise, taping will help ensure that your foot is properly aligned. Consider visiting a medical professional or physical therapist to demonstrate the most beneficial and proper taping technique.
Anti-inflammatory Medication: Over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, and naproxen can help to ease bunion inflammation and pain
Hot/Cold Bunion Therapy: Alternating ice and applying heat to a bunion can provide temporary pain relief caused by a bunion and may also help to reduce any swelling or bursitis in the big toe joint.
Castor Oil. Castor Oil is known as an anti-inflammatory and analgesic (pain reliving) holistic remedy and has been known to relieve the discomfort resulting from a bunion. Wrap a castor oil-soaked cloth around the foot ensuring the castor oil is in contact with the bunion. Then wrap the entire foot with plastic wrap. Finally, place a hot compress on the inflamed area for approximately 30 minutes.
Cortisone Injections: Inflammation of the joint at the base of the big toe and the pain associated with it can sometimes be relieved with a local injection of cortisone, a strong steroid used to reduce inflammation.
Acupuncture: This Chinese medical practice involving the insertion of needles at specified sites of the body has been shown to alleviate the pain caused by bunions.
Although bunions do not always cause pain and discomfort, they are permanent unless corrected by bunion surgery. The goal of most bunion surgeries is to realign the joint, relieve pain, and correct the deformity.
A bunionectomy is the surgical operation used to correct a bunion. This surgery typically involves removing the bony growth of the bunion and realigning the ligaments and tendons of the big toe joint.
An osteotomy is a more invasive surgery, which involves cutting and realigning the bone that forms the bunion. Screws and pins are inserted in the bone to fix the realignment in place.
There are additional types of bunion surgery that include removing part of the bone in the big toe in order to straighten it or joining the bones of the joint permanently. Bunion surgery is generally done on an outpatient basis and lasts approximately one hour, depending on the complexity of the procedure. Surgery is the most drastic bunion treatment and can result in weeks of recovery.
If surgery is the treatment of choice, there are simple things you can do to prepare yourself for both the surgery and recovery. Be sure you are up to date with household chores that require you to be on your feet such as laundry, grocery shopping, and meal preparation. Prepare a post-surgery recovery space such as your bed or couch. Stock the area around your recovery space with items to keep you occupied such as books or electronics.
Bunion Surgery Recovery
As with all surgeries, recovery can in large part be based on how well the patient follows the surgeon’s instructions following the surgical procedure. It is very important for your foot to heal properly, and it may take many months for the healing process to take place.
Depending on the type of bunion surgery the patient undergoes, a walking cast, splint, or special shoes are sometimes worn post-operation. Regular shoes can sometimes be worn in as little as a month after surgery, but cases vary. Any stiches should be kept dry, so the foot must be covered when showering or bathing
Immediately following surgery, your orthopedic surgeon will most likely require that you not put any weight on the affected foot. As the foot heals you will gradually be able to put more weight on it, but premature walking can easily disrupt the carefully reset alignment of your foot and may result in a worsened condition and additional surgeries.
Compliance with a non-weight bearing prescription from the surgeon is often the most difficult post-surgery rule to follow. However, oftentimes it is the most important recommendation. Walkers, canes, crutches, and other crutch alternatives, such as knee scooters or the hands-free iWALK2.0 can facilitate non-weight bearing movement.
Many people find crutches, canes and walkers to be cumbersome. Some even find crutches to be dangerous and difficult to use. If you are tempted to walk without an aid after surgery, be sure to research a crutch alternative such as a knee scooter or iWALK2.0, which will enable you to move more freely while keeping the foot elevated. The iWALK2.0 gives you additional mobility, freeing up your hands and arms and enabling you to maintain your day-to-day routine while keeping in compliance with non-weight bearing orders. However, during the first weeks of walking, limit yourself to only short distances. It may be necessary request a handicap-parking pass from your doctor.
While bunions are a widespread ailment that can cause discomfort and pain, there are a number of surgical and non-surgical treatments that can reduce the symptoms. In addition, advancements in non-weight bearing devices such as the iWALK2.0 can make recovery much less disturbing to your day-to-day life. If you are uncertain as to the severity of your bunion or which treatment makes the most sense to you, we highly suggest that you speak to your medical practitioner.
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