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Bunions (Hallux Valgus) – Symptoms, Causes, Treatments, Surgery and Recovery

Hallux Valgus, or bunions as they’re widely known, are bony lumps that form on the side of your feet. They are very common and most people learn to live with them by making a few simple adjustments like wearing wider shoes. However, sometimes they become sore and painful and if they start affecting your daily life, surgery may be an option. This article explains more about what causes bunions, the main symptoms, and treatment options.

Your Guide To Recovery
What is a bunion?
Common symptoms
Typical causes of bunions
Diagnosing bunions
Treatments for a bunion
Bunion surgery recovery
FAQ

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What is a Bunion?

A bunion is a bony bump that develops on the inside of your foot at the base of your big toe. This joint is known as the metatarsophalangeal joint (MTP) and helps to distribute body weight on your foot when you’re walking, running, or standing.

Bunions form when some of the bones at the front of your foot move out of place. This usually happens slowly, causing your big toe to move towards the smaller toes and forcing the MTP joint to stick out. This condition, which is also known as the hallux valgus deformity, can gradually worsen over time and may start to become painful.


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Common Symptoms

The most common symptoms of bunions are:

  • Your big toe points toward your second toe, or your second toe overlaps your big toe.
  • A prominent bump on the inside of the big toe joint.
  • Pain on the inside of your foot at the big toe joint when wearing shoes.
  • Pain when walking.
  • Redness, swelling, or thickening of the skin on the inside of the big toe joint.

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Typical Causes of Bunions

Bunions are a common condition, affecting around one in three people over the age of 65[i]. Women are more likely to be affected than men because they often wear tight, high-heeled shoes that squeeze the toes together. While experts can’t agree on whether wearing tight shoes actually causes bunions in the first place, they are known to make the problem worse. Bunions are rare in populations that don’t wear shoes.

Bunions often run in the family so sometimes it’s simply down to genetics and there’s nothing you can do to prevent them. If you have arthritis, weak connective tissue, short Achilles tendons or calf muscles, or a joint condition, you’re also at a greater risk. Bunions seem to develop faster in people who are flat-footed.

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Diagnosing Bunions

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Your doctor can usually diagnose bunions simply by examining your foot. However, they may order an X-ray to get a clearer diagnosis on how severe the condition is. They will ask you about your symptoms and watch you walking around to get a feel for your level of discomfort and how much it’s affecting your day to day life.

Bunion Treatments

Most bunions only cause mild symptoms and, while they won’t go away, non-surgical treatment can help to manage and prevent any discomfort they’re causing. However, sometimes they start to cause severe pain and pressure, and if this is affecting your quality of life then it may be time to discuss surgical options with your doctor.

Non-surgical Bunion Treatment

Most people find relief from bunion pain by simply changing the type of shoes they wear. Get your feet measured to make sure you’re wearing the right size and choose comfortable, wider shoes that give your feet and toes ample room to move. If your big toe has plenty of space, it’s less likely to start moving towards the smaller toes. Avoid any heels higher than two inches as this can put too much pressure on the front of your foot.

Tips for proper shoe fit:

  • Size varies among brands, so judge the shoe by how it fits on your foot rather than the size marked on the shoe.
  • Find a shoe that’s similar to the shape of your foot.
  • Measure your feet regularly. The size tends to change as you grow older.
  • Your feet may be different sizes. If so, fit to the size of your largest foot.
  • Be sure to stand during the fitting process.
  • Make sure you can extend all of your toes and that there’s adequate space for your longest toe.
  • Walk in the shoe to make sure it feels right.

You can also try bunion pads, which are soft pads made from silicone, to line the area that presses against the bunion, helping to relieve pain and preventing further bunion growth.

Some doctors recommend using shoe inserts (orthotics). They work by ensuring your foot is properly aligned and reducing pressure on your bunion. Orthotics can be bought over the counter or custom-made for your feet.

Taping your bunion can also reduce the amount of pressure on the inflamed joint and ensure that your foot is properly aligned. A medical professional or physical therapist can demonstrate the most beneficial and proper taping technique.

Over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, and naproxen can help to ease bunion inflammation and pain. Using an ice pack can also help. Wrap a bag of frozen vegetables or ice in a towel and hold it over the area for around five minutes. Don’t use ice on your foot for longer than 20 minutes because this can damage your skin.

Other, less common treatments include a castor oil wrap, cortisone injections and acupuncture. Castor oil is an anti-inflammatory and analgesic (pain reliving) holistic remedy and has been known to relieve the pain caused by bunions. Wrap a cloth soaked in castor oil around your foot, ensuring that the castor oil is in contact with the bunion. Then wrap your entire foot with plastic wrap and place a hot compress on the inflamed area for around 30 minutes.

Taping your bunion can also reduce the amount of pressure on the inflamed joint. Likewise, taping will help ensure that your foot is properly aligned. Consider visiting a medical professional or physical therapist to demonstrate the most beneficial and proper taping technique.

Anti-inflammatory Medication: Over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, and naproxen can help to ease bunion inflammation and pain

Hot/Cold Bunion Therapy: Alternating ice and applying heat to a bunion can provide temporary pain relief caused by a bunion and may also help to reduce any swelling or bursitis in the big toe joint.

Castor Oil. Castor Oil is known as an anti-inflammatory and analgesic (pain reliving) holistic remedy and has been known to relieve the discomfort resulting from a bunion.  Wrap a castor oil-soaked cloth around the foot ensuring the castor oil is in contact with the bunion. Then wrap the entire foot with plastic wrap. Finally, place a hot compress on the inflamed area for approximately 30 minutes.

Cortisone Injections: Inflammation of the joint at the base of the big toe and the pain associated with it can sometimes be relieved with a local injection of cortisone, a strong steroid used to reduce inflammation.

Acupuncture: This Chinese medical practice involving the insertion of needles at specified sites of the body has been shown to alleviate the pain caused by bunions.

Surgical Treatment

If the pain is becoming unmanageable it may be time to think about surgery. This is the only way to get rid of bunions.

Surgery is the most drastic treatment option and isn’t usually recommended just to improve the appearance of your feet. The operation used to correct a bunion is called a bunionectomy. This surgery typically involves removing the bony growth of the bunion and realigning the ligaments and tendons of the big toe joint.

An osteotomy is a more invasive surgery, which involves cutting and realigning the bone that forms the bunion. Screws and pins are inserted into the bone to fix the realignment in place. Other types of bunion surgery include removing part of the bone in the big toe in order to straighten it or joining the bones of the joint permanently.

Bunion surgery is usually performed as an outpatient procedure, so you won’t need to stay in hospital overnight, and it takes around one hour.

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Bunion Surgery Recovery

Bunion Taping and Splint

Recovery takes several weeks so make sure that you make any preparations in advance as you may need some extra help at home. Depending on the type of surgery you had, you’ll need to wear either a cast, splint or special shoes after your operation. You’ll need to avoid getting your stitches wet by wearing a waterproof cover while showering or bathing.

You won’t be able to put any weight on your affected foot for the first couple of weeks after your surgery. It’s important to listen to your doctor’s instructions about this otherwise you could disrupt the newly reset alignment of your foot and make your condition worse.

Once you’ve got the go ahead from your doctor, you can start slowly putting weight on your foot again. It can take up to six months to make a full recovery.

Non-weight bearing is often the toughest post-surgery rule to follow. There’s nothing more frustrating than not even being able to fetch yourself a cup of coffee or feeling like you’ve run a marathon after simply using crutches to hop from one side of the room to the other.

Mobility Options While Non-Weight Bearing

Crutches are the most common mobility device used by patients recovering from lower leg and foot surgeries. They are relatively cheap, easy to get hold of, and lightweight to transport around. However, they quickly become frustrating and exhausting. Not only do you lose the use of your arms and hands, as well as your foot, they can also cause additional pain in other parts of your body.

Knee scooters can be a great alternative because they enable you to move around freely while keeping your foot elevated. You can whizz around on flat surfaces but you can’t use these devices on uneven ground or stairs, and they’re quite bulky to get in and out of cars. In addition, your hands and arms are required for navigating the knee scooter, so are not available for other daily living activities.

The iWALK2.0 hands free crutch is now a popular option among patients. This device functions like a hi-tech peg-leg and allows you to walk around freely and unaided without putting any weight on your foot at all. You have full use of your hands and arms and can use the crutch on stairs and uneven ground. A 2019 medical study found that nine out of 10 patients prefer this device to traditional crutches.
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Bunion-Mobility Devices

FAQs

Here are some of the most commonly asked questions about bunions:

What is the difference between a bunion and hallux valgus?

None! Hallux valgus is the medical name for bunions, as they are more widely known.

Do bunions ever go away on their own?

Bunions won’t go away on their own. The only way to get rid of them is to have surgery.

Should I have bunion surgery?

Surgery is usually only recommended if your symptoms are severe and other treatments haven’t worked. It’s not normally carried out for cosmetic reasons. As with all surgeries, there are risks which your doctor will discuss with you.

In a medical study[ii] of patients who had bunion surgery, 82% were either very pleased or fairly pleased with the outcome eight years later.

Is bunion surgery painful?

Most people will experience some pain and discomfort for the first few days after bunion surgery. Your medical team will advise you on how to minimize any pain and swelling. The long-term aim of surgery is to eliminate the pain caused by your bunion.

Do bunions get worse as you age?

Many bunions are progressive and will get worse over time. Studies have found[iii] that the prevalence of bunions increases with age, particularly in women.

What exercises help bunions?

Foot exercises won’t get rid of your bunions but they can help to relieve some of the symptoms, according to Khurram Khan, DPM, assistant professor of podiatric medicine at the New York College of Podiatric Medicine in Manhattan. They include:

  • Stretching your toes: point your toes straight ahead for five seconds and then curl them under for five seconds. Repeat 10 times.
  • Toe circles: while sitting, hold your big toe and circle it clockwise a few times. Then do the same anticlockwise. Repeat several times.
  • Ball rolls: put a small ball like a tennis or golf ball under your foot and roll it around for a few minutes.
  • Towel curls: Put a small towel on the floor, grip it with your toes and pull it towards you. Repeat several times.

The information above is intended for informational purposes only and is not intended to prevent, treat, or diagnose any illness or disease. We aim to provide the highest quality information, so if you have any questions on the information above, we welcome your feedback!

References

  1. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Bunions: Overview. 2018 Jun 28. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513134/
  2. Patient Preference and Physical Demand for Hands-Free Single Crutch vs Standard Axillary Crutches in Foot and Ankle Patients. Kevin D. Martin, DO, Alicia M. Unangst, DO, Jeannie Huh, MD, Jamie Chisholm, MBA. Foot Ankle Int. 2019 Oct;40(10):1203-1208. Epub 2019 Aug 2.
  3. Unilateral Versus Bilateral Same-Day Surgery Outcomes for Hallux Valgus: An Eight Year Prospective Cohort Study By Jill Dawson, DPhil, Michele Peters, PhD, Crispin Jenkinson, DPhil, Helen Doll, DPhil, Grahame Lavis, BSc (Hons), Robert Sharp, MA FRCS (Ortho), Mark Rogers, FRCS (Ortho), Paul Cooke, ChM FRCS, The Foot and Ankle Online Journal (11): 2 2012.
  4. Wiley – Blackwell. “Prevalence of bunions increases with age; more common in women.” ScienceDaily. ScienceDaily, 25 February 2011.
CITATIONS

Abbate, Skya. “The Relationship Between Bunions, Sugar, and the Spleen.” Acupuncture Today, Nov. 2012, Vol. 3, Issue 11. http://www.acupuncturetoday.com/mpacms/at/article.php?id=28075
Ioli, James. “What to Do About Bunions.” Harvard Women’s Health Watch, June 2011. Web. 25 Feb. 2013. http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2011/June/what-to-do-about-bunions
Kristen. “Better Bunion Surgery Recovery.” The Center for Podiatric Care and Sports Medicine, Healing Feet Blog, 27 June 2012. Web. 25 Feb. 2013. http://www.healingfeet.com/blog/foot-care/better-bunion-surgery-recovery
Mayo Clinic Staff. “Definition of Bunions, Preparing for Your Appointment, Tests and Diagnosis.” The Mayo Clinic. Diseases and Conditions, 25 Jan. 2011. Web. 24 Feb. 2013. http://www.mayoclinic.com/health/bunions/DS00309
Vanderheiden, Terence. “Metatarsophalangeal Joint.” About.com Guide. Health: Podiatry, 22 May 2011. Web. 27 Feb. 2013. http://foothealth.about.com/od/glossary/g/MTPJ.htm

Radovic, Phillip A. “Bunions (Hallus Valgus).” MedicineNet.com. Diseases and Conditions: Bunions Article. June 27, 2014. Web. http://www/medicinenet.com