Bunions Pain Relief
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
At Coastal Podiatry, LLC one of our specialties is bunion surgery. We stay abreast of the most cutting-edge technology and procedures, and utilize them in our practice. Surgery is not always necessary for treating a bunion, but in many cases these bumps on the big toe joint can greatly interfere with our daily lives.
Anatomy of a Bunion
A bunion is a bump on the side of the big toe that occurs when the bone becomes deformed and pushes outward instead of straight. Over time it can result in the big toe overlapping the other toes and causing friction on the bunion against the shoe. It is a condition that often presents with chronic pain because of the constant rubbing and pressure on the largest toe joint.
This foot condition is often seen in women more than men, because one of the leading contributors is wearing shoes that are too tight—including high heels! It is not a problem that happens overnight; rather it is a gradual process of wearing ill-fitting shoes over many years. However, the footwear is not always the problem, as bunions are also linked to flat feet, foot injuries, neuromuscular disorders, and even genetics.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
Non-Surgical Treatment of Bunions
Some of the non-surgical methods of treating this foot deformity include:
- Orthotic devices (over-the-counter or custom-made) to hold the foot in the correction position.
- Protective padding to ease the pain and to avoid friction.
- Wearing shoes that have boxy toes to give plenty of breathing room.
- Removing corns and calluses.
- Using a splint at night to promote correct alignment.
- Exercise or physical therapy for the feet.
If these methods have been exhausted or none of them are helping relieve the pain, then it may be time to consider surgical means.
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe. Bunion surgery is typically an outpatient procedure and can be done in less than an hour. There are over a hundred specific types of surgeries that can be done for these bumps, but some of the most commonly used techniques include:
- Bunionectomy—the removal of part of the bone that is pointing out.
- Metatarsal osteotomy—the removal of pieces of bone from the foot or toes.
- Arthrodesis—the fusing together of the joints in the big toe.
- Lapidus procedure—the fusing together of the joints in the middle of the foot.
- Inserting an implant in the toe.
- Realignment of the ligaments in the big toe.
Even after surgery, there are no guarantees that the bunions won’t return. It is important to follow post-operative instructions very carefully. This might even include not wearing high heels anymore, because of the likelihood of reformation.
What are bunions?
When your big toe is pressed up tight to the toe next to it, the joint at its base may be pushed out at an awkward angle. This forms a bony protrusion on the side of your foot. This widening of your forefoot can cause crowding in the box of your shoes and will most likely result in pain. This deformity usually develops because of genetics or arthritis. Wearing shoes that do not fit properly and are too tight in the toe area, or high heels that put weight on this forefoot, aggravates bunions and leads to soreness. You might also notice that the skin on your big toe gets red and inflamed from the constant rubbing of your toe on your shoes.
How do you treat a bunion?
There are different ways of treating the bump on your big toe. We try to start out as conservatively as possible. This can be as simple as changing the shoes you wear and allowing your toes more room to breathe and move. You can also pad, tape or splint your toes to keep them pointing in the right direction. The use of ice on the affected area may help relieve some of the pain. Some people benefit from custom-made orthotic devices or even an over-the-counter shoe insert. These take the pressure off of your toes and make walking less painful. Your doctor may recommend the use of anti-inflammatory non-steroid medications, but always consult with a medical professional before taking drugs.
When is bunion surgery needed?
If you have exhausted all of these conservative treatment options and nothing is working, it may be time to consider surgical methods. There are different types of surgeries that can be done. These may include removing the swollen tissue, straightening the big toe by removing parts of the bone, realigning the toe bones, and permanently joining the bones of the joint affected by the bunion. Surgery is usually used as a last resort—only when nothing else works in healing your pain.
When to Call a Doctor
It is best to get medical attention at the first sign of this deformity. A podiatrist can recommend a treatment plan for you and make sure the bony bump does not progress to the point where surgery is necessary. Call Dr. Rahn Ravenell and Dr. Tamika Ravenell or schedule an appointment online. Coastal Podiatry, LLC in Mt. Pleasant, SC is your one-stop shop for all of your podiatric needs. Treating bunions is just one of our specialties, but it is one of the things we do very well. Give us a call and stop pain in its tracks.