HomeBunions ResourcesThe Ultimate Guide to Bunion Treatment

The Ultimate Guide to Bunion Treatment

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What is a bunion?

A bunion is a deformation of the bone and joint at the base of the big toe caused by a swollen bursa sac and by the big toe angling inward.

This angling of the toe causes the head of the foot’s first metatarsal to become visible. The bones are then thrown out of alignment, thus causing a bunion or visible ‘bump’ to form.

Bunions worsen progressively over time, and although they begin with the big toe leaning inwards, the angle of the bones in the foot gradually changes to produce the characteristic bump, which becomes increasingly prominent.

When bunions and foot pain develops, this is usually an indicator that the growth is in the later stages when the deformation has become quite severe.

What does a bunion look like?

What Tests are available to diagnose bunion?

Physical examination is usually all that is needed to identify a bunion. The doctor may ask the patient to move his big toe up and down to evaluate his range of motion. In some cases, the doctor may require an x-ray of the injured foot in order to determine how severe the problem is.

The doctor also usually asks questions on the types of shoes the patient wears and how frequently they are worn. Most doctors also ask if there is any family history of foot bunions and past foot injuries.

Who is at Risk of Getting Bunions?

Although anyone can develop bunions, studies have shown that women are ten times more likely to suffer from this condition, most likely because of constrictive footwear and the wearing of high heels. Checkout the latest celebrities with bunions in 2022.

What Causes a Bunion?

The medical consensus is that if you have a genetic tendency towards bunions, bad choices in footwear – especially high heels – will make it very likely that you’ll develop bunions. Like every other body trait, we inherit the good and the bad from our parents, and it’s no different for the characteristics of our feet. In fact, some podiatric surgeons have performed bunionectomies on multiple generations of feet in the same family.

We frequently inherit flat feet, low arches, abnormal bone structure, or loose ligaments and tendons. Any of these biomechanical variations may contribute to the development of bunions and the accompanying pain in your feet. When feet with already weakened biomechanics like these are stuffed into pointy or high heeled shoes too frequently, the stress placed on the front of the foot often results in a bunion.

Other contributing factors are an occupation that demands a lot of time on your feet; wearing shoes which do not support your feet correctly; hormonal changes and sudden weight gain like that experienced during pregnancy; and obesity.

Symptoms Of Bunions

Early Signs of a Bunion include:

  • Early movement of the big toe towards the smaller toes
  • Bump on the base joint of the big toe
  • Deep dull “in the joint” pain
  • Pain on top or side of the big toe from shoe pressure

What is A Tailor’s Bunion?

A tailor’s bunion is also a structural change in the foot. The result is a bony deformity at the 5th metatarsal phalangeal joint. The 5th metatarsal moves laterally, and the 5th toe moves medially, as seen below.

The movement results in a structural change and causes a bump to form on the outside of the foot. The bump may be an enlarged bone or bone spur, as seen to the right. Like bunions, tailor’s bunions may take several years to develop. Read more about tailors bunion and treatment options.

Treatment Options For bunions

Bunions are usually only removed if they cause significant pain or if the bone deformation is severe. When surgical and non-surgical options are available, most doctors will opt for non-surgical treatment first.

Here is a breakdown of standard treatments of both the non-surgical and surgical types.

Non-Surgical Bunion Treatments

Your doctor or podiatrist will most likely suggest non-surgical treatments first, such as:

  1. Bunion correctors and sleeves
  2. Shoes for Bunions
  3. Sandals for bunions
  4. Bunion exercises
  5. Home remedies for bunions
  6. Pain killers

Let’s take a look at these treatments in more detail:

1. Bunion Correctors

bunion treatment at home

Bunion correctors and sleeves are an easy, accessible, and affordable way to reduce pain from this particular deformation. Reusable adhesive gel or felt pads are readily found in pharmacies and regular department stores.

The other option is to purchase a bunion sleeve that slips over the big toe. Both options serve the same purpose: to protect your foot from friction and pressure and prevent the enlarged joint from rubbing against your shoe.

Interested in learning more? We know the feeling. Here’s an article we think you’ll like: How to Buy the Best Bunion Correctors and Splints.


2. Shoes for Bunions

best shoes for people with  bunions

Footwear is a common culprit when tracking down the cause of bunions. When treating bunions, your doctor will question you what type of shoe you generally wear and the frequency with which you are wearing constrictive shoes or high heels.

Wearing wide-toed shoes that fit well and give ample support to your arches will give your toes plenty of room and decrease pressure on your bunions. Heels that exceed a height of two inches should not be worn.

Want to dive deeper into the recommended shoes? Read more about: How to Buy The Best Shoes for Bunions (Men & Women)


3. Sandals for bunions

best sandals for people with bunions

 We can’t get enough sandals this summer season. There are just so many super cute and ultra-chic and trendy designs, shapes, colours and heights to choose from!

Sandals are our weakness, but fortunately, if you suffer from bunions, you cant jump right in into any pair.

But how do you know where to buy these sandals? And how do you know thwy are the right sandals for bunions? You can find the answers in Which are the Best Sandals for Bunions (Men & Women)


4. How to Shrink Bunions Naturally

How to Shrink Bunions Naturally

Relieving bunion pain at home is the goal of all bunion sufferers so they can avoid surgery.

Home remedies include over the counter bunion products to protect your bunion from rubbing against your shoe and toe stretchers and separators such as YogaToes, which ease pain by exercising the muscles in your foot.

Epsom salts and castor oil are home remedies for reducing pain that has been around for a long time.

Still curious? Click here to learn more on how to treat bunions at home. Check out How to Shrink Bunions Naturally.


5. Exercises for Bunions

bunion exercises for fast relief
Exercises for bunions

Foot exercises help by slowing the progression of the bunion. Toe stretches and foot exercises keep the joint between the foot and big toe mobile, strengthening the muscles controlling your big toe hence maintaining flexibility.

We understand that not everybody is able to exercise but if you can, this might be what you need. Some of this exercises can be performed while seated and others while standing.

Curious as to which are the best exercises to strengthen your big toe? Find out more: The best bunion exercises.


6. Pain Killers

pain killers for bunions

Suppose you are experiencing intense discomfort from a bunion. In that case, painkillers such as ibuprofen or acetaminophen can help ease your pain, but using over-the-counter medication to dull the pain is not a long-term solution.

Be sure to follow all directions for use, and it is highly recommended that you see a professional for long-term care.


Surgical Bunion Treatments

Your doctor or podiatrist may turn to surgical options if your symptoms are severe and you fail to respond positively to the non-surgical options presented above. While those options are designed to alleviate discomfort and prevent the symptoms from getting worse, the only way to get rid of a bunion is to remove it surgically.

Bunion surgery is usually not performed for cosmetic reasons alone, and while up to 85% of surgeries are successful, care must be taken because bunions can return after surgical intervention.

The style of shoe you wear may be permanently limited due to the risks associated with restrictive or heeled footwear.
Several factors need to be evaluated when considering this type of surgery:

• Age
• General health
• Occupation and lifestyle
• Severity of affliction

While surgery of this type is not considered a ‘major’ surgery, the patient is carefully evaluated before going under the knife. Here is an expanded outline of the extenuating factors evaluated before surgical treatment for bunions will be granted:

Considerations Before Bunion Surgery

1. Age

Age is a factor for bunion surgery, not just because of the anaesthesia involved. Still, because young people run an increased risk of the bunion returning for several reasons, including that their bones are still forming, they tend to be more active. They also tend to forgo sensible shoes for fashionable footwear.

This generally means that unless the problem is debilitating non-surgical treatments should be put into place as best as possible until the patient is older.

2. General Health

Evaluating your general health is a standard procedure for any surgery; pre-existing medical conditions can prevent, or interfere with, the healing process.

For instance, diabetes often affects the circulatory system, which increases the risk of infection and delayed healing of wounds, both of which are severe problems for recovering surgery patients.

It is imperative that all candidates fully disclose their medical histories and their current health state before proceeding with any surgery.

3. Occupation and lifestyle

Occupation matters greatly when considering bunion surgery; if you are a professional dancer or athlete, this type of treatment will likely not be a realistic option until retirement.

Likewise, lifestyle is an important consideration as well; if you lead an active life that involves sports and physical activity, joint mobility will likely be a priority for you (surgery may decrease the range of motion in your toes). An active lifestyle increases the chances of the bunion returning post-surgery as well.

Bunion surgery may cause reduced mobility in the foot even if the rest of the healing goes well.

4. Severity of Affliction

Surgery for bunions is usually only an option if you are in severe pain and non-surgical remedies have failed to alleviate symptoms or prevent the problem from worsening.

There are risks and complications with any surgery, and bunion surgery is no exception. Whether or not to undergo this invasive treatment will be made with your GP or podiatrist.

Read this post that explains how ane of our patients cured her bunion: How i cured my bunion.

General Surgical Procedures

Regardless of the type of surgery decided upon, a local or general anaesthetic will be administered. A minimum of one incision will be made in the big toe area to allow surgical instruments to be inserted and manipulated, sometimes with the help of x-rays.

Post-surgery requirements may include a plaster cast or other dressing to stabilize the toes and foot in the correct position, though you may be given a unique shoe that allows you to walk by putting pressure on your heel.

Types of surgery

There are several different types of surgical procedures used to treat bunions. The severity of bone deformation and displacement will dictate the method used for each patient. The overall condition of the joint will be evaluated as well.

Surgical treatment may involve using screws or pins to hold everything in place during the healing period, though some of these tools may be permanently left in the foot.

The following list outlines the most common types of surgery for this type of affliction:

1. Osteotomy

This is the most common surgery performed for bunion correction, wherein the protruding lump is removed from the bone in the toe so that the foot structure can be correctly realigned.

The toe joint will also be realigned, and this too may involve removing auxiliary pieces of bone that are not a part of the visible deformation.

Distal Soft Tissue Realignment
This type of surgery is most often used to treat a mild deformity of the bone. The bunion is minimized through soft tissue manipulations such as tendon release and capsular tightening.

This type of treatment aims to improve the stability of the big toe joint specifically and the foot in general. While this type of treatment can be performed independently, it’s usually used in tandem with an osteotomy.

2. Arthrodesis

Arthrodesis is usually only proscribed for bone deformities that are too severe to be fixed with other treatments as it requires fusing the two bones in your big toe joint together.

Cases involving severe rheumatoid arthritis or radical deterioration are prime candidates for this type of surgery. Arthrodesis is not generally recommended for younger patients because the big toe will no longer move at the base (the metatarsophalangeal joint will become immobilized.)

3. Keller’s Arthroplasty

Keller’s Arthroplasty is also called an Excision Arthroplasty as it involves excising the bunion and part of the afflicted joint bone of the big toe. A ‘false joint’ forms along with the resulting scar tissue, which involves using temporary wires to pin the common in place for roughly three weeks post-surgery, at which point the pins are removed.

This procedure is reserved for severe and difficult to treat bunions in very elderly patients.
Minimally Invasive Bunion Surgery

This is a new type of surgery being explored by The National Institute for Health and Clinical Excellence (NICE). Still, as the procedure is unique, there is little reliable information on its effectiveness—and the safety—of this procedure.

Post Surgery Care

After bunion surgery, you can expect foot and ankle swelling to occur for three months and sometimes longer. You will be required to keep your foot elevated to minimize swelling, and you will need crutches when moving around.

You should not wear your usual shoes for three to four months post-op; in fact, you may be required to wear special shoes that allow you to walk on your heel while protecting the incision.

A plaster cast or other forms of bandages may be used to keep bone and soft tissue in place during the healing process.

Your doctor or podiatrist will also discuss modifying the type of shoe that you should wear. You will be encouraged to wear flat or low heeled, wide-fitting shoes with good arch support that are ideally made from leather to avoid constricting the pressure points of the feet and toes.

Post-surgery foot care is crucial to avoid another bunion and foot pain from developing once again.

Preventive Measures include:

  • Wear wide-fitting toe box shoes
  • Avoid constrictive, high heeled shoes
  • Exercise your feet
  • Wear a corrective flexible bunion splint

FAQ

What is bunion surgery?
Bunion surgery is the procedure to remove the bone of the big toe and foot. 

Why do you need to remove your bunion?
Some people suffer from extra large bunions on their foot.  If this does not cause you any foot pain, then bunion removal is not unnecessary.  However, many people suffer foot pain when wearing shoes caused by the big bunion, especially women.  Sometimes wide shoes just don’t work and are too hard to find.

How is the bunion removed?
Removing the bunion on your foot requires surgery where they must cut your bone or repair the tissues on your foot.  Bunion surgery must reconstruct your big toe bone and may require screws and plates to be placed in the bone during recovery.  This surgical procedure is mostly an outpatient procedure and you will be able to recover at home.

Will my life be affected in any way after bunion surgery?
Most people recover fully from the surgery, but like any surgery, there are risks.  Most likely, you will have a better pain free foot and live your life normally after recovery.

Conclusion

Resources

https://www.bunioninstitute.com/

Christine
Christine
Dr Christine Nolan is the CEO and founder of Footdiagnosis.com. She also has extensive clinical experience and is therefore uniquely qualified to detect and manage diseases of the lower extremities including those related to peripheral arterial disease and diabetes.