A bunion is an enlargement or bump on the inside of the big toe joint. They usually begin as the big toe moves toward the smaller toes.
As the big toe moves towards the smaller toes it puts pressure on the great toe joint and pushes it outward. The outward direction of the joint is what you see as the bunion deformity.
What Causes Bunions?
Bunions are often caused by incorrect foot mechanics. The deformity does run in families; however, the foot type is hereditary, not the bunion.
Usually, the flattening of the arch causes excessive forces and jamming through the big toe joint. This jamming of the joint pushes the big toe inward and the the joint outward, leading to pain and joint degeneration. Arthritic conditions may also cause bunion deformities and pain in the great toe joint.
Women and Bunions
Women are more frequently affected with bunions because of tight, pointed, flat or high heeled shoes. Unsupportive shoes place excessive pressure through the joint causing the bunion deformity. Tight shoes aggravate the condition. Wearing high heeled shoes is especially stressful on the joints of the foot.
What Causes Pain in the Big Toe Joint When Bunions are not Present?
Excessive pressure in the big toe joint can occur even when no bunion is present. This condition is called Hallux Limitus and can lead to pain and arthritis within the joint. Like bunions, hallux limitus is caused by improper foot mechanics and is treated in a similar manner. Hallux limitus is a progressive deformity and early treatment can help prevent future problems.
Treatment
Bunion treatment varies depending on your foot type, severity of the deformity,
your activities and your symptoms. Evaluation by a physician specializing
in the foot should be sought at the first sign of a bunion condition, so
severe deformity and arthritic changes can be avoided. SHOES-n-FEET®has
developed relationships with some of Puget Sound's best foot doctors and
we are happy to refer you to a specialist in your area.
Early Treatment
The primary purpose of early treatment is to relieve pressure within the big toe joint and to diminish the progression of joint damage. The main conservative therapies include:
• Proper Shoes: Properly fit shoes can dramatically reduce pressure on a bunion.
• Shoe Modifications: Shoes can be stretched or modified to better accommodate your foot.
• Over-the-counter arch supports: Arch supports reduce the rate of the arch flattening & putting excessive force on the joints
• Functional custom orthotics; prescribed and cast by you're a foot doctor with specialized training in orthotic therapy. SHOES-n-FEET®can help you find a specialist in the Puget Sound region.
• Accommodative Padding
How Do Over-the-Counter (OTC) Orthotics help?
With mild foot conditions an over-the-counter arch support may be adequate to control your symptoms. SHOES-n-FEET®has a large selection of OTC arch supports. Our shoe fitting specialists or your podiatrist can give you recommendations on the best over-the-counter devices for your foot.
Bunions are progressive deformities and will get bigger over time if not treated correctly. The correct orthotic or arch support can help prevent progression. To give yourself the best chance at relieving pain and preventing surgery, we recommend that you consult your podiatrist before using any supports in your shoes.
Functional Orthotics and Bunions
If you do not have significant deformity or joint damage, custom functional orthotics are often useful in controlling abnormal foot mechanics and preventing the need for surgery.
Functional orthotics when prescribed and cast by a doctor, usually a podiatrist, are precision medical devices which correct for your particular foot abnormality. Custom functional orthotic devices have the greatest chance of reducing the forces through your joint, reducing your pain, and helping you avoid surgery.
When is Bunion or Big Toe Joint Surgery Needed?
When you start to have joint pain or the bunion condition limits your activities and all conservative options have failed, surgery may be necessary. Joint pain may indicate degeneration of the joint cartilage. One of the goals in surgery is to realign the joint to prevent further loss of joint cartilage.
Pain and deformity are significantly reduced in the majority of patients who undergo bunion surgery. Bunion surgery allows for realignment of the joint. After surgery the foot should be able to carry the body's weight in a more normal fashion. Postoperative orthoses may be recommended to improve foot function and limit excessive forces through the great toe joint. Wearing supportive shoes with an orthotic is the long-term solution to prevent the pain from returning.
Although surgery is sometimes necessary, our podiatric consultants conservative treatment is usually successful at relieving bunion and big toe joint pain and that conservative options should be tried first before considering surgery.
Once again, if you have any symptoms of bunion deformity or have pain
in your big toe joint, you should see a foot doctor for a complete evaluation.
If you would like to have your foot evaluated or if you have questions
on the above information, we can refer you to a foot health professional
in your area.
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