While some causes of bunions can’t be avoided, such as genetics and other diseases, you can take steps to minimize risks and avoid making developing bunions worse.
What Are Bunions?
Many women have bunions, which are deformities of the metatarsophalangeal (MTP) joint at the base of the big toe. Bunions develop when the first metatarsal bone in the foot turns outward, and the big toe points inward, causing the joint to protrude. Because most shoes don’t accommodate the resulting protrusion, pressure is put on the misaligned joint, which eventually causes the bursa (fluid-filled sac that surrounds and cushions the joint) to become inflamed. Eventually, the entire joint becomes stiff and painful as a result.
Bunions can be triggered by poor choices in footwear (wearing narrow shoes or shoes with pointed toes can trigger bunions, for example), but bunions are largely hereditary because some people's inherited foot type is either more prone or less prone to bunions than others. People who have low arches, flat feet, or loose joints or tendons are at increased risk for developing bunions. The shape of the metatarsal head (top of the metatarsal bone) also can affect your risk: if it is rounder, it means the joint is less stable and more likely to result in a bunion when squeezed into shoes that have narrow toes.
Even heels with rounded toes may increase bunion risk. High heels exacerbate bunions because they tip the body’s weight forward, forcing the toes into the front of the shoe and adding pressure on the joint. This may explain why bunions are 10 times more common in women than in men.
Your occupation may have an effect on the risk for developing bunions: Women who work in occupations like teaching or nursing, in which daily tasks involve a lot of standing or walking, are more susceptible to bunions than office workers who spend the majority of their days seated. Ballet dancers, whose feet suffer severe repetitive stress, are also at risk of developing bunions. Pregnant women, whose bodies release hormones that loosen ligaments and flatten feet, may also be at an increased risk for developing bunions, and women with arthritis, which damages the cartilage within the joint.
Am I At Risk?
Several factors contribute to an individual’s risk for developing bunions. Among the risk factors for developing bunions:
● Inherited Foot Type: Some foot types are more prone to bunion formation than others, so if bunions run in your family, you may be at a higher risk for developing them yourself.
● Foot Injuries: Foot injuries, or repeated stress on the foot, as in the case of ballet dancers, can increase your chances of developing bunions.
● Congenital Deformities: Deformities present at birth, called congenital defects, may increase your risk of developing bunions.
● Arthritis: Bunions are associated with certain types of arthritis, particularly the inflammatory types, like rheumatoid arthritis (RA).
● Profession: Women who work in fields that require them to spend long periods of time on their feet are more prone to developing bunions.
● Footwear Choices: Wearing high-heeled shoes, particularly those that force the toes into the front of the shoes and crowd the toes, put you at an increased risk for developing bunions. Similarly, wearing shoes that are too tight, too narrow, or too pointed can increase your chances of developing bunions.
What Are the Symptoms?
Bunions develop when the pressure of bearing and shutting your weight fall unevenly on the joints and tendons of your feet, making the MTP joint unstable, and eventually deforming the foot. In addition to the characteristic bony bump at the base of the big toe, signs and symptoms of bunions may include:
● Red, inflamed skin on the side of the big toe
● A noticeable turn in the big toe, with the big toe pointing toward the other toes
● Thick skin on the underside of your big toe
● Calluses on the second toe
● Foot pain that can be either persistent or come and go
● Difficulty moving your big toe or pain when moving the big toe
● Corns or other irritations that develop as a result of the overlap of the first and second toes
How Are They Treated?
You may be able to relieve bunion pain and prevent bunions from getting worse by taking conservative measures aimed at taking pressure off the MTP joint and improving foot mechanics. Most cases are handled this way; however, severe bunions, bunions that accompany an underlying deformity that can’t otherwise be corrected, or debilitating, painful bunions may require surgical options to correct them.
If you notice that you are developing a bunion, you can take steps at home to stop the bunion from developing further and ease bunion pain:
● Apply a commercial, nonmedicated bunion pad around the bony protrusion
● Wear shoes that have a wide toe and deep toe box
● Apply ice packs several times a day to inflamed, painful bunions
● Avoid heels that are more than two inches tall
It is important to make an appointment with a podiatrist when you notice the symptoms of a bunion because identifying this deformity early in its development and treating it properly is essential to avoiding surgical correction.
Your podiatrist may recommend:
● Padding and Taping: One of the first steps in bunion treatment is padding the bunion to minimize pain and allow you to continue an active life. By keeping the foot in a normal position, taping also helps reduce stress to the foot.
● Physical Therapy: Physical therapy (PT) is often used to provide relief from inflammation and bunion pain. Ultrasound therapy is a popular form of bunion treatment.
● Medication: Medications such as anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation from joint deformities.
● Orthotics: Shoe inserts may be useful in controlling foot function and may reduce the symptoms of bunions.
● Surgery: When conservative treatments fail or if medical attention is neglected until the bunion has progressed past the threshold for these treatments, surgery may be a necessary step to relieve pressure and repair the toe joint.
Although bunions may never cause further issues, they are permanent unless surgically corrected. Mayo Clinic outlines some complications that may occur as a result of bunions, including:
● Bursitis: This condition arises when the small pads that provide cushioning for your bones, tendons, and muscles near the joints become inflamed.
● Hammertoe: This condition is characterized by an abnormal bending in the middle joint of the toe, most commonly the second toe, that can cause pain and pressure.
● Metatarsalgia: This might lead to pain and inflammation in the ball of the foot.
Taking care of your feet and seeing the doctor when something might be wrong are steps in the right direction to healthy feet.