A very common foot condition, a bunion is a bony bulge that forms on the metatarsophalangeal joint at the base of the big toe.
Affecting more than 3 million people a year in the US, bunions are more common in women than in men. They occur when the first metatarsal bone of the foot (the bone in the big toe) faces inward towards the other toes. This causes the metatarsophalangeal joint to protrude out, causing swelling, pain and in some cases, severe discomfort.
Symptoms of a Bunion
Bunions are usually pretty painful and include:
- A visible bump on the outside of the big toe
- Consistent calluses or corns on the foot
- Swelling, redness or severe tenderness around you’re the MTP joint
- Pain in the toe – which can be persistent or occasional and can include a dull, burning, or stabbing-like pain
While getting bunions can be hereditary, one of the biggest environmental causes is wearing poorly-fitted shoes. When feet are constantly squeezed into a narrow, or pointed shoe, the big toe compresses against the other smaller toes, eventually causing the fluid-filled sac that protects the joint to become stiff and inflamed. After some time, the MTP joint begins to shift inward and becomes deformed. As a result, the MTP joint protrudes out from the foot, forming into a bunion.
People with flat feet, low arches and weak joints are more at risk to developing bunions. The shape of a top of the metatarsal bone can also play a big factor. A bone that is too round, the MTP joint is not as stable and can become deformed when the foot is squeezed into narrow shoes. One of the reasons women are more at risk is because they tend to wear high heels, which propels the body’s weight forward and pushes the toes to the front of the shoe.
A foot specialist will typically take an in-depth x-ray and asses the difference in angles between specific bones in the foot. That information will show them how severe the bunion is and give insight into how to proceed with treatment.
The type of treatment of a bunion depends on how much pain it causes, and how deeply the person’s quality of life is affected. Non-surgical treatment options include:
- First and foremost, changing shoes, if currently worn shoes are too narrow, big, or uncomfortable.
- Over-the-counter painkillers containing acetaminophen, naproxen, or ibuprofen can be taken to alleviate pain on demand.
- Special shoe inserts can be placed into shoes to evenly distribute foot pressure, which can prevent the bunion from getting worse.
- Wearing special bunion toe pads can help manage the pain and also reduce stress on the bunion.
Surgery should only be considered if non-invasive bunion treatment doesn’t provide relief of symptoms. If the bunion is not in the way of everyday activities such as walking, running, or affecting work performance, surgery should be avoided. However, if the condition worsens over time and affects the quality of life surgery is a very common option, too. Keep in mind, however, recovery after this type of surgery can take anywhere from a few weeks to a few months, although most people resume walking almost immediately.
Some common surgical procedures for bunions may include:
- Realigning the big toe by removing part of the bone
- Permanently fusing the bones of the affected MTP joint
- Removing swollen tissue from the area around the joint
People Most at Risk for Developing a Bunion
Teachers, food servers, nurses, construction workers, and dancers, including workout instructors, are some of the most commonly affected people due to constantly being on their feet at work. Older persons with arthritis can develop bunions as a result of their already weakened joints. Although more common in the older demographic, younger people can also develop bunions, especially if it runs in their family and if they tend to neglect their feet.