Bunion Symptoms, Causes & Treatment Options

Bunions are bumps formed on the side of the base of the big toe caused by a mixture of genetics, shoes, and foot shape.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is A Bunion?

Summary

Bunions are present on the foot at the base of the big toe. This article will summarize the causes of bunions as well as the treatment and prevention of bunions.

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Bunion Symptoms

Main symptoms

The main symptoms of a bunion include widening of the food, altered alignment of the toes, toe or foot pain, difficulty walking, numbness, skin thickening, joint inflammation, and osteoarthritis of the toe, and unsteady gait or risk of falling.

  • Widening of the foot: Bunions are cased when one of the bones of the big toe, the metatarsal bone, juts inward toward the rest of the toes. The joint between this big toe is called the metatarsophalangeal joint and is slowly altered to point gradually inward overtime. This widens the base of the foot and creates a body point along the joint line.
  • Altered alignment of the toes: All forms of a bunion involve altered alignment of at least one toe. This altered alignment causes a toe to point inward toward the others and if the inward deviation is large enough can affect the alignment of the other toes and the ability to walk comfortably and without pain.
  • Foot pain: Misalignment of the toes can cause pain as the toes rub against each other or as the widened feet rub against shoes. Over time, as the area that holds the stress of standing, walking, and running changes, the feet can undergo severe pain from increased pressure on areas not designed to hold stress.
  • Difficulty walking: Severe bunions can cause difficulty walking as they cause pain, alter the structure of the feet, and decrease the ability of toes to adjust and balance the gait.
  • Numbness: Over time, nerve damage can occur in the big toe because of the altered angle leading to numbness and pain.
  • Osteoarthritis of the toe: Inflammation of the joints of the toe can be caused when pressure is placed on the joints and wear and tear of the cartilage increased by stress placed on the joint over time.
  • Fall risk: Because of a lack of sensation in the toes of the feet, altered balance, and loss of strength of the toes because of misalignment, bunions also cause an increased risk of falling.

Bunion Causes

Bunions are more common in women than men and may be partially genetic. They can be caused or worsened by narrow-toed or high-heeled shoes. Over time, they can cause the joint at the base of the big toe (e.g., the metatarsophalangeal joint/MTP) to jut outwards toward the opposite foot. Individuals with weak connective tissue or inflammatory joint diseases have a high risk of developing bunions. In some cases, the rubbing of the MTP joint against a tight shoe can lead to inflammation of the joint which can cause pain, blisters, calluses, or aggravate an already inflamed joint.

Joint inflammation

Bunions can be worsened by joint inflammation overtime and that inflammation can be caused by pre-existing conditions like rheumatoid arthritis or by continued trauma to the affected digit like continued bumps or bruises of an MTP or continued pressure upon an MTP as is common when wearing high heeled shoes.

Weak connective tissue

Individuals with weak connective tissue are purported to have a high chance of developing bunions. While the link is primarily anecdotal, those individuals that have weak connective tissue are thought to have a higher propensity to have the toe move out of alignment with continued pressure.

Restrictive footwear

Medical literature appears undecided on whether bunions are caused by restrictive footwear. There are many individuals who wear restrictive footwear who will not develop bunions and many individuals who do not wear restrictive footwear who will develop bunions. However, anecdotally, it appears that narrowed toes and high heels may aggravate a pre-existing bunion.

Pronation

Pronation or rotating the foot such that the outside of the foot is lifted, and the inside of the food moves downward is associated with bunions formation. Individuals that pronate while walking place more pressure along the ball of the foot and may contribute to moving the foot inward and increasing bunion formation.

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Treatment Options, Relief, and Prevention for Bunions

Treatment

There are many options for treatment of bunions that range from the splints and painkillers to surgery to alter the shape of the joints.

  • Splints: Toe-spacers or toe-supports for nighttime use that can be used to force the toe into standard position over time (similarly to how braces reposition teeth). They are used commonly to alleviate symptoms and stop the bunion from progressing but they do not correct misalignment.
  • Spacious shoes: Properly-fitted shoes that do not provide excess pressure upon the toes are important and in cases of mild bunions may help arrest progression or allow a return to normal.
  • Painkillers: Over-the-counter non-steroidal anti-inflammatory drugs are important adjuncts to reduce pain and inflammation for individuals with bunions.
  • Surgical repair: Preliminary research suggests that the most effective way to treat severe bunions is through surgery. Both cosmetic and functional results are thought to be better non-surgical interventions if there is enough time and follow-up for post-surgical care.

Prevention

Prevention of bunions involves wearing comfortable non-elevated shoes and ensuring the treatment of any inflammatory joint conditions.

When to Seek Further Consultation for Bunions

If you are experiencing numbness, non-healing wounds, intense pain, blue or cold feet, or pus draining over the joint, you should seek medical evaluation. If you require or would like to know about surgical fixation, you should have your feet evaluated by a medical professional or foot specialist.