Bunions Causes, Symptoms & Treatment Options

The big toe is made up of two joints, those being the interphalangeal (IP) and metatarsophalangeal (MTP) joints. Bunions occur at the MTP joint and take the form of a bulging, bony, and possibly painful, bump.

A bunion, also called hallux valgus, forms when the bones of the big toe move out of alignment and the first metatarsal bone of the foot juts outward, causing the big toe to point inward toward the other toes.

Bunions typically develop slowly, with the condition starting as a small bump and becoming more pronounced over time. As the condition worsens, you may experience pain from the bump and the crowding of other toes.

Bunions typically result from:

• Heredity (inherited foot shape)
• Birth deformity
• Poorly fitting shoes – e.g., too tight, narrow, or high heels
• Inflammatory conditions – e.g., rheumatoid arthritis or polio
• Injuries to the foot (bone, muscle, ligament) that cause the bone to heal out of place

Any strenuous activity that involves the feet can contribute to the development of bunions. This is not limited to sport but can include work in which you spend a lot of time on your feet.

Common signs of bunions include:

• Pain
• Tenderness over bump
• Redness and inflammation
• Difficulty walking (in later stages)

Many instances of bunions require no medical treatment, but if the bunion becomes painful or if you are having difficulty with shoe wear or activities, then contact your physician.

The doctor will conduct a physical examination of your foot. This is usually enough to diagnose a bunion. However, your doctor may also prescribe an X-Ray. MRIs are usually not necessary in these cases.

Most cases of bunions can be treated without surgery. Depending on the severity of the condition, your doctor may recommend:

• Changing footwear – e.g., shoes with a wider toe
• Padding – e.g., silicone pads worn inside the shoe
• Orthotics (external leg braces)
• Nonsteroidal anti-inflammatory drugs (NSAIA) such as Ibuprofen to alleviate pain and swelling

If conservative treatment fails, then surgical intervention may be necessary, although it rarely requires a hospital stay.

Outpatient surgery is only conducted on painful bunions and can include many different operations, such as:

• Exostectomy – A simple removal of the bump. This is not often recommended as the bump may return.
• Osteotomy – A realigning of the bones. Many different procedures are described for bunion correction, with the aim of restoring the big toe to its proper position.
• Fusion – For patients with bunions and arthritis.
• Resection – Removal of the damaged joint. This is mostly recommended for elderly patients or those with low demands on the feet.

After surgery, you may need to wear bandages and sometimes a splint. Weight bearing on the affected foot should be reduced, and the total recovery time may take between 3-6 months.

You can return to play when you have regained full range of motion and strength without any pain.