Bunions: The 411

That painful bump on the joint at the base of your big toe? Thank your parents and/or your grandparents. While wearing tight shoes or high heels can exacerbate bunion pain the real culprit is genetics—a bunion starts with certain inherited structural tendencies of your foot, including low arches, flat feet, loose ligaments, or abnormal bone structure. Even children as young as ten years old (more often girls than boys) can develop what’s called an “adolescent bunion” because of their innate foot structure. Fortunately, bunions in young people don’t generally restrict movement in the joint of the big toe and can be addressed with custom orthotics or other inserts that will gently redirect the growing foot.

Unlike many foot conditions, a bunion takes time to develop. Pressure on the big toe—that’s where shoes come in—forces the toe inward towards the second toe at the joint where the foot bone and the toe bone meet. Over time the structure of the bone changes and the telltale bony protrusion develops. A bunion becomes a problem when it gets inflamed to the point that any added pressure—even just the flexing involved in walking–causes pain.

Bunions can vary tremendously from individual to individual. They always start out small and in some people, they remain small, but for many people, they get worse over time, especially if they are confined in tight, narrow shoes. In extreme cases the big toe may angle so severely inward that it crosses the second toe and begins a domino effect down the line of toes; toes that are pushed out of alignment might then develop hammertoes and painful calluses and corns. In other people the bunion might not be on the big toe at all—a bunionette (sometimes called a “tailor’s bunion” for the cross-legged position tailors once sat in to do their work) is a small bunion on the joint of the little toe.  Though small in size a bunionette can be as painful as a big bunion, becoming inflamed and developing corns and calluses.

What can you do about your bunion?

It is important to note that bunions are a progressive and irreversible condition, which means there is nothing you can do to “fix” your bunions without surgery. However, there are things you can help slow the progression of the condition. The basics begin with your choice of footwear: bunion prevention is just one of the many reasons to wear comfortably fitting shoes with plenty of room for your toes. In addition, most drug stores carry protective bunion shields, either padded or filled with gel, that can offer some relief; be prepared to try a couple of different types before you find the one that works with your foot, and be careful that the padding doesn’t make your shoe tighter and ultimately increase the pressure on your bunion. Your doctor might also recommend orthotic shoe inserts, toe spacers, or a splint that you wear at night to gently push the toe into a straighter position. Icing the bunion several times a day can help to reduce swelling; a non-steroidal anti-inflammatory medication may also help to keep down the pain and swelling.

The surgical option

If your painful bunion just won’t cooperate no matter what you do it may be time to talk to your doctor about a bunionectomy. During bunion surgery, the doctor not only shaves off the excess bone, but also reconnects your bones, ligaments, tendons, and nerves to permanently realign your toe. Typically done as out-patient surgery, the procedure does involve a recovery time during which you can return to most normal activities but will be wearing a surgical boot or shoe.

The podiatrists at the Triad Foot & Ankle Center’s four locations can help you consider your options in treating your bunion.  Call 336-375-6990 to schedule your appointment or visit our website www.triadfoot.com to request an appointment.

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