Bunions: Causes, Symptoms and Treatment

By Dr. Mercola

Your foot is the foundation of your ability to move, walk, run, jump and stand. Each of your feet and ankles has 29 different bones, accounting for over 25 percent of the bones in your body. The American Podiatric Medical Association found that 77 percent of people over 18 years suffer from foot pain.1

Failure to walk and run with proper form and posture can result in tight muscles, changing the form and function of the joints in your foot. Flip flops, tight shoes and high heels can trigger changes in your foot structure leading to pain and deformity.

Simple exercises and proper footwear can make a big difference in the potential development or progression of bunions. By the time you reach age 50, your feet will likely have traveled 75,000 miles.2 No wonder so many people experience so much discomfort and pain.

What’s a Bunion?

Bunions are an anatomical deformity possibly resulting from a congenital structural defect or may be initiated from poor foot function and tight musculature. Constricted muscles and tendons exert a strong force on the joints of your foot.

An area often exhibiting deformity from those forces is the joint between your big toe and your foot. This is where bunions commonly form. Bunions may also form on the other side of your foot, in the joint between your little toe and the long bones of your foot.

Thickened skin may also develop over the bump. This area may become swollen and inflamed, contributing to your pain and discomfort from bony changes.

When the bunion forms between the base of your big toe and the first metatarsal bone (long bone of your foot), it creates an imbalance in how your weight is distributed over your foot joints.

This increases the deformity and the discomfort. When the bunion forms between your little toe and the fifth metatarsal it’s called a bunionette.

How Bunions Form

Although most bunions develop in adulthood, bunions may develop in adolescence as well. Among adolescents, they most frequently occur in girls between 10 and 15 years of age. Women are also at greater risk for developing a bunion or bunionette than men.3

There are several factors that increase your risk of developing a bunion. You have control over some of these factors, and others are a function of your bone structure and development.4

Wearing high heelsWearing narrow shoesArthritis, notably rheumatoid arthritis
Foot injuriesFeet don’t develop properly before birthUneven weight bearing, which makes a joint unstable
Tight muscles and tendonsInherited foot type

Each of these factors places your foot in an unnatural position. Consistent use and weight bearing on your foot in a poor position may encourage your muscles to become less flexible. A lack of flexibility will increase your risk of a bunion deformity.

Dr. Georgeanne Botek, head of the section of Podiatry and medical director of Cleveland Clinic’s Diabetic Foot Clinic, says, “Bunions often run in families but they can be the result of the way we walk or the shoes we wear.”5

What You’ll Feel

Before you experience symptoms, you’ll often see the changes in your foot. A bump will begin to form on the outside of your foot just below your big toe or your little toe in the case of a bunionette. Once the bunion grows larger you may experience more symptoms including:6

Pain over the skin where the bunion rubs on your shoesPain and soreness over the bony area
Numbness around the bunionBurning sensation
Swelling at the joint where the bunion formed, especially after being on your feetThicker skin over the base of the affected toe
Redness over the skin from rubbing on your shoes or originating deeper from inflammation at the jointNew corns or calluses on other toes as your weight is poorly distributed
Movement restriction in the affected joint

These symptoms are frustrating, painful and restrict the type of footwear you may be comfortable wearing. Without treatment and care, your bunion may grow so large that even wide-toe shoes are not wide enough to accommodate the deformity.

What Are Your Options for Treatment?

There are several different options for treatment. Personally, I believe that surgery is the very last resort you should consider. Although a surgical procedure may affect the anatomical structure, it will not address the underlying condition that caused the bunion in the first place.

I have a bunion I’ve been treating for years. Treatments have reduced my pain and discomfort and almost stopped the progression of the changes to my foot.

Bunions are permanent unless you have them surgically corrected. However, with other less-invasive treatments, you can reduce the symptoms of pain and discomfort, slow or stop the progression and improve the flexibility of your foot and joints. Ohio podiatrist Dr. Dina Stock told the Cleveland Clinic:

“For many people it may simply be a matter of wearing properly fitting shoes. Be sure to choose low-heeled, comfortable shoes that provide plenty of space for your toes and the widest part of your foot.”7

7 Options for Treating Bunions at Home

Try these methods at home to reduce inflammation, improve the flexibility of your foot and reduce the stress over your bunion.8

1. Reduce the Pressure

By reducing the pressure over the bunion you may find relief from pain. Protect the bunion with moleskin or a gel-filled pad. Wear shoes that provide plenty of space in the toe box.

Shop at a store where the staff will measure your foot and fit you with the right size shoe. You might be surprised to learn that your real shoe size is not the one you’ve been buying for the last several years.

2. Increase Circulation

Whirlpools, warm socks, hot packs, ultrasound and massage can all increase the circulation to the area, helping to reduce inflammation and promote healing.

3. Reduce the Inflammation

Ice and curcumin or turmeric may help to reduce the inflammatory response in the bunion and reduce your pain.

4. Improve Flexibility

If you have a bunion, you may notice that the toe with the deformity is not as flexible as the same toe on the other foot. The large toe may become so inflexible you can only move it a couple of degrees. This inflexibility contributes to the development of a bunion.

It might be tempting to treat only the toe with the bunion, but you may not get the same results as when you treat your whole foot. It’s a little like the domino effect. The way you bear weight over your feet affects how your knees, hips and lower back function.

Your big toe affects how the rest of your foot functions. When one area has problems it affects the areas around it. Watch the video below to see the proper stretches you can do at home to improve the flexibility of your whole foot.

5. Strengthen Your Muscles

Flexibility is important, and so are strong muscles. Your foot is the foundation of your daily activities and your athletic performance. Regular foot exercises, combined with improved flexibility, may improve how your foot functions and reduce the progression of your bunion.

Imbalances in the strength of the muscles in your foot affect proper walking and running form and limit full range of motion in your foot. Both factors increase your risk of injury and bunions.9 To strengthen the muscles in your foot:

Pick up a washcloth or marbles with your toes to strengthen your arch.Draw the alphabet in the air with your big toe to strengthen your ankle.
Stand on one foot (without holding onto anything) for 10 to 20 seconds. Balancing strengthens your whole foot and improves your overall balance.Roll a tennis ball or foam roller under your foot to stretch your plantar fascia. This is a tough tendon running from the ball of your foot to your heel.
While barefoot, rise up on your toes, strengthening your calves and foot.Lift each toe individually from your big toe to your little toe, then put them back down in reverse order.
While barefoot, put your weight on your heels and spread your toes on both feet as far as you can. Do this while maintaining your balance.

6. Splinting

Wearing a night splint is another option that can help stretch the muscles around your big toe and improve your flexibility. As your toe is held in the correct position and the muscles become more flexible, the long bones in your foot are no longer being pulled out of alignment.

When study participants wore a splint at night and a shoe that’s orthotic with a toe separator during the day, they experienced statistically significant pain relief.10 This particular study did not note any structural changes to the foot, but it only looked at results after three months of treatment. Bunions take years to develop and may require a similar amount of time to see significant reversal of bony deformity.

Do Orthotics Really Help?

Orthotic is the term used to describe a shoe insert designed to change the way your foot bears weight. Orthotics are sold over-the-counter or may be custom-molded to your foot by your podiatrist. Although orthotics are popular, and used by many athletes, not all experts are convinced they are useful.11

The basic function is to put your foot in a better position and take stress off of an injured area. However, giving your foot muscles a permanent vacation means your muscles will get weaker and less flexible.12 Orthotics decelerate the velocity of pronation and distribute the force of your footfall over a broader area, reducing the stress on any one part of your foot. Although helpful in the short term while an injury heals, they are not recommended for long-term use.13

Pick the Right Shoe

The shoes you choose have a direct bearing on the health of your feet. Even if you love your flip-flops, it might be time to give them up. As you walk in such shoes, your toes increase their gripping action, causing chronic tension in your toes in a flexed position that eventually alters your balance.14

The absolute right shoes for your feet might just be no shoes at all. When you surround your feet with padding and lifts to correct what shoe manufacturers perceive as defects in the way you walk, you place your foot in an unnatural position and create an imbalance in your feet and body. Thus, the muscles in your feet are not used correctly, changing the degree of strength and flexibility you should have.15

Of course, there are concerns with going barefoot. You probably can’t go without shoes at work, and walking outside presents problems with sharp stones and other debris. However, when done properly, you can successfully enjoy time without shoes and, as a result, stronger feet and a reduced risk of bunions.

Spend most of your time at home out of shoes, practicing your “fox walk.” Shoes encourage you to strike your heel on the ground first, while walking like a fox is easier on your joints, knees, hips and lower back. With knees bent, the ball of your foot strikes the floor first, rolling back to your heel. Your knees remain bent, without ever locking or being straight. It’s virtually soundless and the way that children walk before they get into shoes.

If you have diabetes, which can lead to diminished sensation and ability to feel pain in your feet, then walking without protection on your feet is not recommended, even at home. Stepping on an errant pencil or sharp object may pierce the skin on your feet without your realizing it, increasing your risk of an infection.

You May Be Able to Prevent Bunions

It is much easier to prevent bunions than it is to correct them. Pay attention to the strength and flexibility of the muscles in your feet. Six-pack abs might be the cosmetic addition you want for your summer wardrobe, but they also play an important role in reducing back pain and protecting your abdominal organs.

The same is true for the muscles in your feet. By stretching and strengthening the muscles you may help prevent the development of an unwanted cosmetic change to your feet. Follow the recommended stretches and strengthening exercises, avoid wearing tight shoes or high heels, and go barefoot as much as possible while you’re at home.

Sources and References

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