Bunions are deformities that occur at the joint at the base of the big toe. The first long bone in the foot, called the first metatarsal, shifts outward at the metatarsophalangeal (MTP) joint, creating a protruding bump on the side of the foot and causing the big toe to shift toward the second toe.
The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion’s bump.
Bunions Get Worse Over Time
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Without proper treatment, they can worsen over time.
When bunions get larger, they become more painful and may lead to additional problems, such as bursitis or a hammertoe. Bursitis is an inflammation of the fluid-filled sac that cushions the joint. Bunions cause the MTP joint to become enlarged, which may lead to bursitis. Bunions can also lead to misalignment of the second toe, as the big toe angles further inward, causing a painful hammertoe.
Causes and Symptoms of Bunions
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.
Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may, therefore, appear sooner.
Symptoms usually appear at later stages, although some people never have any. Common symptoms, which occur at the site of the bunion, may include:
- Pain or soreness
- Inflammation and redness
- Burning sensation
- Possible numbness
Bunions are prominently visible at the base of the big toe or side of the foot, but not all cases are alike. Some bunions progress more rapidly than others. Your foot and ankle doctor will order x-rays to determine the degree of the deformity and assess the changes that have occurred over time. Once your doctor has evaluated your bunion, a treatment plan can be developed that is best suited to your needs.
Bunions can be treated both nonsurgically and surgically. Your foot and ankle surgeon will recommend the best option for you depending on the degree of your deformity.
Nonsurgical Treatment Options
Sometimes observation of the bunion is all that is needed. To reduce the chance of damage to the joint, your foot and ankle doctor may schedule periodic evaluations and x-rays. Custom orthotics may also be recommended to change the way the foot is interacting with the ground, thus slowing the progression of the deformity.
In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they won’t reverse the deformity itself. These include:
- Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition.
- Avoid activity that causes bunion pain, including standing for long periods of time.
- Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Applying an ice pack several times a day helps reduce inflammation and pain.
- Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
In most cases, addressing the deformity through the use of custom orthotics is the most effective way of slowing the progression of this condition and improving the patient’s comfort level.
Surgical Treatment Options
If nonsurgical treatments fail to relieve bunion pain or the pain of a bunion interferes with daily activities, it is time to discuss surgical options with your foot and ankle doctor. Together you can decide if surgery is best for you.
A variety of surgical procedures are available to treat bunions. The procedures are designed to remove the bump of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain.
In selecting the procedure or combination of procedures for your particular case, your foot and ankle doctor will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
Bunion Treatment in Portland, Oregon
At Summit Orthopaedics, our foot and ankle surgeons offer a full range of nonsurgical and surgical treatments for bunion relief. If you would like to set up a consultation, please call (503) 850-9940 to schedule an appointment.