a bony growth called a bunion on a patientA bunion is a well-recognized condition of the foot, primarily due to its unsightly nature. But bunions are more than displeasing to look at. A bunion can completely change the shape of your foot. At best, this makes it difficult for you to find shoes that fit correctly. At worst, this leads to a painful deformity that requires advanced medical treatment.  

The good news is that painless bunions, when treated early, often respond well to preventative care approaches, and no foot surgery is required. Our goal is to help you seek this sort of noninvasive care as early as possible, to minimize your risk of needing surgery later in life. Please use the following information as needed to ensure your feet are properly cared for:

What Is A Bunion & What Are Its Symptoms? 

A foot bunion, also known as hallux valgus, is a painful bony bump that develops on the inside of the foot at the big toe joint. Specifically, bunions develop at the metatarsophalangeal joint (MTP) joint, which is the largest of the two joints that make up the big toe. 

While some foot issues present themselves very quickly, this particular foot deformity develops slowly over time. Through prolonged exposure to pressure, a person's big toe is forced to lean toward their second toe. This forces the normal bone structure of the foot and big toe joint to change, and this change in structure is what creates a visible bunion bump. 

As this structural change worsens, it often makes it painful for people to wear shoes, walk, or engage with other normal activities. And because the MTP joint flexes with every step, the bigger the bunion gets, the more painful and difficult walking can become.

In addition to the visible bump on the inside of the foot and problems with walking, additional symptoms of a bunion may include:

  • big toe joint pain
  • general foot pain and tenderness
  • redness and inflammation
  • hardened skin on the bottom of the foot
  • a callus or corn on the bump
  • stiffness and restricted motion in the big toe

Why Does A Bunion Form? 

Bunions can form as the result of a variety of contributing factors. The most common one is people wearing poorly fitted shoes; this is because shoes with a narrow, pointed toe box that forces our toes into an unnatural position are extremely hard on the feet. However, in some cases, genetics (i.e. an inherited foot shape and structure) or even a pre-existing inflammatory condition (ex. rheumatoid arthritis) may increase the risk of a bunion developing on the foot.

In Addition To Pain And A Visible Bump, Are There Other Complications?

In the worst-case scenarios, advanced bunions can greatly alter the appearance and function of the foot. For example: 

  • the big toe may cross under or over the second toe
  • pressure may force the second toe out of alignment in addition to the big toe
  • calluses may develop where the toes rub against each other, causing additional discomfort and difficulty walking

 Additionally, in some cases, advanced bunions may also lead to medical issues and complications. For example: 

  • an enlarged MTP joint may lead to bursitis, a painful condition in which the fluid-filled sac (bursa) that cushions the bone near the joint becomes inflamed
  • chronic pain and arthritis can occur if the cartilage covering the joint becomes damaged
  • one or more toes may develop hammertoe - a foot condition in which the toe has an abnormal bend in the middle joint

Who Is Likely To Suffer From A Bunion?

Bunions can affect anyone in the right circumstances, but they are more common in women. This is because women are more likely to wear tight, narrow shoes that squeeze the toes together. This creates the ideal conditions for foot and toe problems, including bunions, to form.

How Is A Bunion Treated?

Bunion treatment is always dependent on how advanced a person's condition is. With that in mind, there are a combination of care options that doctors may recommend on an individual basis to alleviate the effects of a bunion:

  • Change in footwear. In many cases, bunion growths and pain can be addressed successfully by changing a person’s footwear. Specifically, patients will need to switch to shoes that fit properly and do not compress the toes.
  • Use padding as protection. Protective 'bunion-shield' padding can help cushion the painful area over the bunion, relieving painful symptoms. This method will need to be combined with proper footwear, which will be large enough to accommodate the padding.
  • Invest in orthotics. Some patients may also be advised to wear over-the-counter or custom-made shoe inserts (orthotics) to further support their feet. This type of support with help correct any alignment issues that led to bunion formation.
  • Rest, ice, and medication. Sometimes it takes time for the effects of adjusted footwear to kick in. When managing the painful symptoms of a bunion, immediate relief may be found through these sorts of remedies.

Before prescribing treatment, your doctor will typically ask you about your medical history, general health, and symptoms. They will also conduct an examination of the affected foot a bunion. Usually, this evaluation is all that is needed to confirm a diagnosis. Sometimes an x-ray is also ordered to provide doctors with a look within the foot itself, to check the alignment of your toes and look for damage to the MTP joint. 

What If None Of These Help? 

If none of these methods provide relief, or if a bunion continues to grow worse, surgery may be recommended to treat a bunion. Like other foot and ankle surgeries, bunion surgery is a method of treatment that’s only prescribed after conservative, non-surgical avenues of care are explored but do not provide major improvements.

Bunion surgery will put in order any misaligned bone, ligaments, tendons, and nerves contributing to a bunion’s formation. Through surgery, the big toe will be restored to its correct position, allowing doctors to provide pain relief, reduce inflammation, and restore a normal shape to the afflicted foot.

 If you’re struggling with a bunion, you may be a good candidate for bunion surgery if:

  • you’re dealing with significant foot pain that prevents you from fully engaging in daily activities
  • you struggle to walk even a few blocks without significant pain
  • inflammation and swelling of your big toe never improves, even with rest and medication
  • you experience a visible deformity of the big toe as it pushes towards the second toe, in addition to a bump

What Should I Expect From A Visit To Your Practice? 

As an orthopaedic practice, Prisk Orthopaedics and Wellness specializes in the range of issues that may affect the foot and ankle. We are up-to-date and progressive in the numerous care options that are available to you (both surgical and nonsurgical) in the event of experiencing foot and ankle problems.

If your bunion is painless, we will discuss preventative care approaches meant to prevent your bunion from worsening. Our non-surgical treatment options include rest, inserts, braces, therapy, medications, injections, and biologic regenerative treatments.  

Should surgery become necessary, you will be fully advised on your care needs and next steps.

When discussing your foot and ankle needs, you can expect to meet directly with our Medical Director, Dr. Prisk. He is a board-certified orthopaedic foot and ankle surgeon with sub-specialty fellowship training and over 10 years of experience in treating complex conditions of the foot and ankle, both surgically and non-surgically. His specialist evaluations can focus on joint, bone, tendon, ligament, or muscle pain, injury, or deformity. 

To receive your evaluation and begin discussing your care needs, please contact Dr. Prisk at (412) 525-7692 or submit an online appointment request form.

Image Courtesy of Wikimedia.org