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Hallux Valgus (Bunions): Causes, Characteristics & Treatment

Hallux Valgus (Bunions): Causes, Characteristics & Treatment

What are Bunions?

The scientific name for bunions is hallux valgus. They are bony bumps that form on the joint where the big toe meets the foot. This joint is called the metatarsophalangeal (MTP) joint. When the joint becomes misaligned, a bunion develops on the foot. It forms over a period of time and the longer it goes unchecked, the larger it gets. Finally, the bunion protrudes and starts to impact the big toe and in extreme cases, it may affect the next toe (x).

Some of these bumps are initially painless. However, over time as the bump grows larger, the bunion can cause the toes to cluster together, which causes pain and increases the likelihood of a permanent deformity. The skin over the bump is usually sore and red (x). To prevent bunions from getting worse, doctors advise that patients wear free, non-restrictive shoes. Wearing narrow, tight shoes can worsen the condition and they can even cause it in the first place!

Bunions often develop as a result of an inherited structural defect, because of stress to the foot or they may be a result of a medical condition like arthritis (x). In some cases, bunions are a symptom of an underlying condition called progressive bone disorder (x). Small bunions (bunionettes) can also develop on the joint of the little toe (x).

A bunion can cause the big toe to lean toward the second toe instead of straight ahead. When the big toe pushes against the next toe, it makes the joint stick out and could cause several problems (x).

Characteristics of Bunions

Apart from the formation of a bump at the base of the big toe, there are several other characteristics and symptoms (x).

  • Swelling and bone and joint pain in the big toe
  • Pain and swelling in the big toe joint
  • Swelling, redness, soreness and tingling in the toes
  • Corns and calluses that form on the joint between the first and second toe
  • Periodic or shooting pain in the big toe
  • Harder skin at the base of the toe
  • Restricted movement in the affected toe
  • Painful lumps under the skin on the bottom of the foot 
  • The big toe turning toward the other toes

Patients who experience any of these symptoms should visit a doctor immediately for further examination.

Characteristics of Bunion

Causes of Bunions

Generally, bunions are a genetic condition. They develop because of a defective foot structure that a patient inherits from their parents. This doesn’t take away from the numerous external factors that could aggravate the development of bunions. Over the years, researchers have discovered that bunions may be the cause of other symptoms such as numbness in the feet (x).

Other factors can also cause bunions to form on the joint, including flat feet, abnormal bone structure and flexible ligaments. Other conditions that can worsen bunions include small or narrow shoes that crowd the toes together and put pressure on the big toe and shoes with pointed toes or high heels. These can force the toes together (x).

Arthritis or injuries to the foot can cause a bunion, as well as standing for long periods of time. Certain ailments that affect the nerves and muscles can cause a bunion, such a polio. Patients can develop bunions if the big toe moves very often or if they suffer from overpronation, which is a low arch in the foot and tendons that stabilizes the big toe (x). Patients are also at a greater risk of developing bunions if the feet do not develop properly before birth.

Living with Bunions

Surgery is the only way to completely get rid of a bunion. However, there are multiple steps to help relieve bunion pain and slow down the rate of progression.

Wear the Right Type of Shoes

The best sneakers for bunions are loose and comfortable. The toe area should be as wide as possible and the heel should be between 1 and 2 inches. Make sure the shoes provide support to the arches of the feet (x).

Make an effort to steer clear of flip-flops and other forms of shoes that don’t provide support to the arches of the feet because it puts additional pressure on the big toe joint. Purchase bunion shoes to help protect your joints.

Know your measurements to avoid narrow shoes. When choosing shoes, it is better to opt for toe separator shoes. Avoid choosing shoes based on the number size. Companies number their shoes differently, so try to pick shoes based on what feels comfortable and not just the shoe size (x).

Use inserts and pads in the shoes. Bunion pads help the foot maintain the correct alignment, which supports the arch. These pads are available at local drugstores or patients can have them custom made to suit their needs.

Exercise and Rest the Feet

 Work your toes. Take off your shoes for a while and just wiggle your toes for a few minutes to relieve pressure on them. Toe spacers can also help ease pressure on the toes. Keep the feet rested as often as possible if you get the chance. Elevate the feet while sitting to reduce pain and swelling. If the pain continues to flare up, patients can take nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen to relieve pain and reduce inflammation (x, x).

Exercising the feet can help manage bunion pain and keep them from getting worse. Patients with bunions may have more pain and trouble walking if they have weak muscles in the feet (x). There are multiple exercises to help strengthen the foot muscles. Here are a few of them (x):

  • Place the heel and the ball of the foot (forefoot) firmly on the floor, lift up the toes for about five seconds and release.
  • Place the heel and the forefoot on the floor and then lift the toes and spread them apart. Reach the little toe towards the floor and move the big toe towards the inside of the foot. Hold that position for five seconds and then release.
  • With the knees bent and the feet on the floor, lift the heels up while pressing down with the big toe. Hold that position for five seconds and then release.

Do these exercises with bare feet. Perform each exercise continuously until the muscles in the feet are tired. You can do these exercises standing on one foot, standing on both feet or sitting in a chair. Begin with whatever exercise feels comfortable to you and work your way up to the subsequent exercises.

Treatment for Bunions

Many patients wonder how to get rid of bunions. There are surgical and non-surgical options for the treatment of bunions.

Nonsurgical Options

If a patient prefers to use non-surgical means to treat a bunion, they have several options. Make sure to wear shoes that have padded soles and enough wiggle room for the toes. Arch supports in the shoes may also support the foot and reduce pressure. Taping the foot can contort it into a normal position and inadvertently reduce pressure on the bunion. Take NSAIDs, like naproxen or ibuprofen, to manage pain and reduce swelling. Injections, such as cortisone injections, can also help reduce swelling (x).

Surgery

If non-surgical options do not help, a doctor may propose surgical options. Doctors have the luxury to select from multiple surgical procedures. However, the most common bunion removal technique is a bunionectomy. Surgical bunion removal is ideal for individuals with pain and inflammation that doesn’t show signs of improvement with other treatment methods. If the toe crosses completely over another toe or if the patient feels so much stiffness that they cannot bend or straighten the toe, they may be a good candidate for surgery (x).

Bunion surgery is very intensive and complete surgery can take up to six months with regular trips to the doctor within that period. Here are some of the options available for hallux valgus surgery (x).

Osteotomy

This corrective procedure realigns the joints. The doctor will use screws, plates or pins to fix the defective bone. The process increases the length of the toe and reduces the weak joint tissues, repairing ligaments and tendons (x).

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Exostectomy

This process removes the bump from the toe joint. Usually the patient undergoes an exostectomy paired with an osteotomy because it does not resolve the underlying cause of the bunion (x).

Bunionectomy

This procedure corrects the position of the big toe by removing some of the bone and swollen tissue from the affected joint. Recovery time for a bunionectomy may last about six weeks to recover, maybe longer. Patients usually leave the hospital after the surgery, but some individuals may stay in the hospital if they receive a more complex surgery. However, the surgery may cause swelling and pain for six months to a year (x).

Arthrodesis

This procedure removes arthritic joint surfaces and forms them back together with screws, wires or plates. Usually patients with severe bunions or arthritis undergo an arthrodesis. Doctors may also perform this procedure on patients who have had unsuccessful bunion surgery in the past (x).

Resection Arthroplasty

This procedure is reserved for older patients with bunions, patients who have previously undergone bunion surgery that did not resolve the problem and patients with chronic arthritis that cannot go through arthrodesis. This process removes the most damaged part of the toe joint, leaving more space between the toe bones (x).

Supplements for Bunions and Healthy Joints

Supplements can help manage the symptoms of bunions and relieve pain or discomfort. They may even help the body slow down the rate of progression. There are several supplements that may be able to help manage pain. However, supplements are not a proper form of medical treatment. Always consult a doctor before starting a supplement regimen and follow all medical advice.

Chamomile

This is a popular supplement for its calming effects after ingestion. Historically, chamomile has both medicinal and cosmetic benefits. It may also help relieve pain and inflammation in arthritis, which can cause bunions. As a supplement, the recommended dosage for chamomile extract powder is 800 mg once or twice a day with water.

Curcumin

Curcumin is derived from turmeric and as a naturally occurring antioxidant, it has anti-inflammatory properties that may benefit overall health and help ease bunion pain. Studies state that it may also provide relief after surgery (x). Take 1,000 mg of curcumin 95% natural turmeric extract powder per day with food or water, unless a physician recommends a different dosage.

Methylsulfonylmethane (MSM)

This natural chemical is a sulfur-based compound that aids and supports healthy joints. MSM can help reduce joint pain and manage arthritis symptoms. As a supplement, the ideal dosage for MSM powder is 1,000 to 1,300 mg up to four times per day, or as directed by a doctor.

Taurine

One natural way to help relieve bunion pain is performing exercises to strengthen the feet, which may cause pain and soreness. Taurine helps the muscles recover after exercise and reduce sore muscles. It can also help prevent muscle damage and reduce inflammation. The recommended dosage for taurine powder is 500 mg, twice a day unless a doctor advises a different dosage.

The Bottom Line

Bunions are painful bumps that form on the big toe joint when it becomes misaligned. Bunions may be a result of injury to the foot, arthritis or medical conditions that weaken the muscles, such as polio. Wearing narrow shoes or shoes with high heels or pointed toes can also crowd the toes and cause a bunion to form. Patients can prevent and manage their bunions by wearing shoes with wiggle room for the toes. It may also be beneficial to avoid shoes that don’t provide arch support, such as sandals or flip flops. Bunions can cause pain and discomfort and they may also cause difficulties walking or affect the other toes on the foot.

There are surgical and non-surgical treatment options to treat a bunion. For example, wearing supportive and comfortable shoes may help and patients can take pain medication to help ease swelling and discomfort. Surgery removes the bump from the foot and aims to correct muscles and ligaments. Supplements may also help promote healthy joints, manage arthritis that can cause bunions and they may even help patients recovery from surgery to treat bunions. However, it is always best to consult a doctor before taking any supplements. They are not a replacement for medical treatment, even though they can help maintain bone and joint health.

 
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