Bunions: Who Gets Them & Why

Bunions:  More than just a bump on the foot.

If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.

Bunions are a common problem that most people experience as a bony protuberance at the base of the big toe. A bunion, however, is more complicated than simply a bump on the foot.

What are bunions?

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The misalignment causes the big toe to move outward. The normal position of the big toe (straight forward) becomes outward-directed toward the smaller toes. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint, or MTP joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain.

A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion.

Bunions facts:

• Bunions involve enlargement and repositioning of joints at the ball of the foot.
• Bunions most commonly affect the inner foot but also can affect the outside of the foot at the base of the little toe.
• Bunions most commonly affect women.
• Bunions may or may not cause symptoms.
• Treatment of bunions can include rest, alteration of footwear, foot supports, medications, and/or surgery.

Who develops bunions? 

More than half the women in America have bunions. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Too-tight shoes can also cause other disabling foot problems like corns, calluses and hammertoes.

Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital), nerve conditions that affect the foot, such as rheumatoid arthritis, and injury to the foot.

To minimize your chances of developing a bunion, never force your foot into a shoe that doesn't fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may also try protective pads to cushion the painful area.

How is a bunion diagnosed?

The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot is assessed during the examination. X-rays of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions.

How are bunions treated?

The goal of treatment of a bunion is foot comfort. In early bunion deformities, the use of soft leather shoes that provide a wide toe box to minimize pressure over the bunion is the treatment of choice. As the deformity progresses, surgery may need to be done to correct the deformity. There are many different types of bunion repairs designed for different foot deformities. Further discussion about surgical repair is completed prior to scheduling surgery.

Following surgery, careful postoperative care is needed in order to keep the toe and metatarsal in proper alignment. Frequent office visits are necessary to inspect the incisions and to re-wrap the foot in a corrected fashion. It is not usually necessary to be cast postoperatively and usually a compression dressing with toe strapping will be used for 8 weeks and the patient will use a bunion shoe to walk in during this period of time.

To schedule an appointment with or to find a medical provider near you, call 877-401-3627 (DOCS) or visit www.saintalphonsus.org/docs today.