When people think of a bunion, certain stigma tend to come to mind.

Many might imagine a bony bump on the toe of an old woman, the culmination of a lifetime worth of poor shoe choices.

However, this isn’t exactly the case! Bunions are not limited to a certain age group or even a certain gender. They have the potential to happen to many different types of people.

The other stigma bunions tend to have is the inability to treat them effectively without surgery. Also not true! There’s much that can be tried to manage bunions and bunion pain without going under a knife.

Here are the facts on bunions and how they can be treated.

Bunions

What Causes a Bunion?

A bunion (also known as “hallux abductovalgus” if you want to get medical), is a bump that forms at the joint residing at the base of the big toe.

This bump develops as the bone of the big toe gradually shifts toward its neighboring toe over time. This shift can become so severe that the two toes may overlap.

Additionally, the bone forced to jut out along the side of the foot may become overgrown, adding to its prominence.

A bunion might not always hurt, especially in early stages of development, but can sometimes become painful, red, or swollen. Corns and calluses may also develop where the bump rubs along your footwear or the two toes rub against each other.

In some cases, a sac of fluid that serves to protect the bone can become inflamed as a consequence of a bunion; a condition known as bursitis.

Are Shoes Really a Culprit?

The big question many people have is whether bunions are caused by wearing heels or shoes that are too tight in the toes. The answer to that is: shoes don’t really cause bunions, but they can definitely make bunions worse.

The root cause of bunions tends to be a weak or abnormal foot structure. Over time, excess stress can be placed on the bones of the big toe (i.e. metatarsals) due to one’s gait or how weight is supported on the feet. This can lead to the ligaments and other tissues around the big toe joint loosening and weakening, causing the shift.

Bunions are not just a “high heels” problem. A foot structure that can lead to bunions tends to be inherited down the family tree. It is more than possible for men to develop bunions, as it is for young patients who have never worn heels or tight shoes (juvenile bunions).

That said, a foot that is susceptible to developing a bunion will almost always have that conditioned worsened by wearing ill-fitting shoes or shoes that compress the toe box. You’re essentially taking a loose post in the ground and leaning on it with this sort of behavior!

Are Shoes Really a Culprit?

Finding Relief from Bunions

As with many other foot and ankle conditions, there is a clear rule for bunion treatment: the sooner a developing bunion is acknowledged and management begun, the better!

It’s not very likely that you can turn back the clock on how far a bunion has developed without the use of surgery. But steps can be taken with early bunions to slow or prevent them from becoming worse. This is especially true in juvenile bunion cases, when growth is still happening and development is more malleable.

The primary focus of bunion treatment will always be managing the symptoms and finding relief from discomfort. If that can be done, then surgery does not have to be put on the table.

Some of the easiest ways to manage bunions is via shoe and lifestyle choices. Shoes that allow more room in the toe box and a more flexible composition can provide surprisingly fast improvement. Additional cushioning and support may be provided in the form of small inserts, and over-the-counter medications might also be prescribed for swelling and pain.

When additional or more advanced support is needed for an abnormal foot shape, custom functional orthotics can help control one’s gait and deflect excess pressure away from the site of the bunion.  

What About Surgery?

Although efforts will always focus on managing symptoms and slowing progression, there are some bunion cases that are just too severe or too unresponsive to conservative methods. In these cases, surgery may be considered.

There are a number of different forms of bunion surgery. In general, procedures may involve cutting and realigning the bone. Just where these cuts and adjustments are made along the bones and joint will depend on a case by case basis.

We should stress that bunion surgery is recommended mostly for relief of pain and symptoms. Surgery for cosmetic purposes is often not suggested, as the risks of surgery may outweigh the aesthetic results.

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