Bunions: Preventions and Treatments - By: Paul V. Spiegl, MD
Did you know wearing tight, narrow, high-heeled shoes can aggravate bunions? A bunion (medical term: hallux valgus) is a bony prominence that develops at the joint at the base of the big toe. When your shoe pushes your big toe against your next toe, the joint of the big toe can be gradually levered out to protrude from the inner side of the foot. This is shown below as the bunion progresses from stage 1 to 2 and to 3. A bunion is not a growth but rather a big toe that is coming out of joint. The skin over the bump might appear red and sore from it rubbing against the inside of the shoe or pain may occur in the joint itself as it is partially dislocated.
It’s a Family Affair
Although some bunions are caused by injuries or by inflammatory arthritis such as rheumatoid arthritis, heredity plays a major role in the development of a bunion. Most people who have a bunion have at least one close family member with a similar problem. Studies have shown that the foot joints of people who develop bunions are shaped differently than those in people who do not.
Blue Suede Shoes
All bunions are permanent and once they begin they can worsen until surgery is required. However, there are steps that can be taken to slow and sometimes stop the progression and ease the discomfort. Start by wearing footwear that fits properly and is comfortable. Shoes should be wide where the foot is wide, provide ample room for toes, and should be made from a soft material that stretches, like suede or leather. Additional measures include:
- Wearing a bunion sleeve on the foot to straighten the toe to lessen the bunion rubbing on the inside of the shoe.
- Using a bunion pad which has a donut shape and transfers the pressure from the bunion to the surrounding area
- Wearing orthotic shoe inserts to improve the position of the foot in the shoe.
- Taking non-steroidal, anti-inflammatory drugs, such as Motrin, to reduce pain and swelling.
- Maintaining a normal body weight will lessen the pressure on all your joints, including feet.
- Warm soaks, ice packs, whirlpools and massages can help ease discomfort.
The Final Countdown: Bunion Surgery
If these options fail to provide relief and bunion symptoms are interfering with work or the recreational activities you enjoy, bunion surgery should be considered. Bunion surgery is not simply removing a bump but a much more complicated procedure which realigns the bones, joints, tendons, ligaments and muscles of the great toe and forefoot. There have been well over 100 operations described to correct bunions. A thorough preoperative evaluation is necessary to determine which procedure is appropriate for you. For more extensive surgery, full recovery to get back to running and competitive sports can take up to six months. A more limited procedure is sometimes appropriate, but the procedure selected should be strong enough to make a bunion recurrence unlikely. Bunion surgery is an investment to provide function and comfort for the rest of your life. Fortunately, technology continues to improve procedures, shorten recovery time and lead to better outcomes. Physical therapy following surgery can shorten the overall recovery process and optimize the results.
The Goals of Bunion Surgery
In general, the common goals of most bunion surgeries include:
- Realigning the great toe and forefoot
- Restoring optimal function of the great toe and foot
- Relieving pain
Bunion Surgery: Everything You Need to Know
The American Academy of Orthopaedic Surgeons has comprehensive information pertaining to bunion surgery. Answers to common questions about the various surgical procedures, as well as answers about potential complications, recovery time and physical therapy exercises can be found at
Your specific bunion condition, the options to manage both non-operatively and operatively, and the advantages, disadvantages and expectations of each can best be determined by an evaluation including a history, physical examination, and x-rays obtained by a foot and ankle specialist.