Maybe you have a bunion. Or maybe one of your parents does, and you’re wondering what your risk might be.
Either way, you probably have a lot of questions. What is it? What does my future look like? What are my treatment options?
We hear you.
Bunions are an extremely common foot deformity, with a complex set of causes, possible symptoms, and treatment options.
Fortunately for you, bunion treatment is one of our top specialties at North Austin Foot & Ankle Institute. So to help you out, we’ve put together this blog. It should give you (almost) everything you need to know about this condition—and what you can do about it.
Without further ado, let’s jump in!
What Is a Bunion?
Yup, we’re starting all the way at the beginning.
The short answer: A bunion is an enlarged, bony bump that forms right on the side of your foot, at the base of your big toe.
The longer answer?
Essentially, the joint at the base of the toe—the metatarsophalangeal joint, or MTPJ—becomes destabilized. This causes a couple of things to happen:
- The big toe itself drifts out of alignment, toward the other toes. The tip of the toe may push into, or sometimes even completely cross overtop of, the second toe.
- As a result of this misalignment, the MTPJ enlarges and begins to “stick out” on the side of the foot. That’s the “bump” you see (and feel).
Worth noting: Although it’s less common, the same process can occur on the other side of your foot, involving the smallest toe rather than the largest. This is called a bunionette, or sometimes a tailor’s bunion.
What Are the Main Symptoms?
The most obvious symptom, of course, is the bump and misaligned toes themselves. You will definitely notice them when you look at your feet.
Beyond that, there may be no symptoms at all—at least in the early stages of the bunion. However, more advanced bunions may be associated with:
- Intermittent to constant pain, whether all the time or during specific activities.
- Restricted motion in the MTPJ, which can impair mobility.
- Development of corns, calluses, and other skin irritations where the toes overlap, or where the bunion is rubbing against the inside of your shoes.
- Inability to wear shoes comfortably.
What Causes Bunions?
We don’t always know what specifically causes each bunion we see. However, there are a few common factors that are strongly correlated with a higher risk of bunion development.
- Genetics. Bunions tend to run in families, and they’re also much more common in women (about 90 percent of cases) than men. If your parents or grandparents had bunions, there’s a solid chance you will develop them as well.
- Foot structure. The reason why bunions tend to run in families has to do with foot shape and structure. Simply put, your foot biomechanics might be poorly optimized, and not able to properly shift excess pressure away from the joint at the base of the big toe. Your foot shape has a lot to do with what kind of feet your parents and grandparents had.
- Poor footwear. Now, there’s still some disagreement in the medical community whether shoes like high heels cause bunions, or if you need to have a flaw in your foot structure first. However, what is clear is that if you are at risk of developing bunions, poor shoes can rapidly exacerbate the problem—and the symptoms.
- Specific injuries. A traumatic or overuse injury to the area surrounding the base of the big toe can destabilize the joint. This can increase the likelihood of developing a bunion.
Do I Need Treatment for My Bunion?
The key thing to ask yourself is whether or not your bunion is causing symptoms that interfere with your daily life. If your bunion isn’t bothering you or preventing you from living an active lifestyle, then “treatments” (even conservative ones) may cause more discomfort than they save.
That said, it’s also important to remember that bunions are a progressive condition, meaning that they do not get better over time—only worse. Furthermore, there may be techniques you can employ that can slow the rate of progression, allowing you to delay further treatment.
This can include:
- Wearing comfortable shoes that properly support your feet. You may need to ditch the heels and stick to wider shoes that accommodate the bunion more generously.
- Stretching and exercising your feet. You might consider exercises like picking up pencils or marbles off the floor with your toes and placing them in a cup. Although this won’t reduce the size of the bunion, it can strengthen supporting muscles and tendons so they can resist further misalignment of the joint.
- Keeping a close eye on your bunions and contacting us if you notice the bump getting worse, or painful symptoms beginning to set in.
Is Surgery the Only Solution?
No, not necessarily.
But let’s clarify here.
Surgery is the only way to correct a bunion, in the sense that the bunion goes away and the foot returns to a normal shape. Conservative treatments cannot do this.
However, the primary goal of any treatment is to relieve pain and enable you to live the lifestyle you want to live.
If conservative treatments can provide that for you, then we are happy to restrict your care to conservative treatments only. In fact, that’s what we (and most of our patients) prefer.
Surgery is only necessary when conservative treatments cannot, or can no longer, prevent the pain from interfering with your daily life.
What Conservative Treatments Are Available?
For starters, go back and re-read what we wrote under “Do I Need Treatment for My Bunion?” All the advice about preventing bunions from worsening—better shoes, stretching, etc.—can apply here as well to help you manage your pain.
You can also add off-the-shelf medications (such as acetaminophen or ibuprofen) and icing as options to the list for short term pain management, if your bunion is relatively mild and pain is only intermittent.
Fortunately, there’s a lot more beyond that we can help you with as well:
- Taping and/or splinting. Depending on how mobile the MTPJ still is, you may be able to use taping or splinting to realign the big toe in a more normal position during the day or while you sleep.
- Padding. Bunion pads may be employed to protect the misaligned joints and toes from pressure and friction. This can be especially helpful if you suffer from corns or calluses related to your bunion.
- Shoe inserts or orthotics. Remember that one of the primary causes of bunions is poor foot structure or alignment, which increases the pressure on the MTPJ. With appropriate shoe inserts or custom orthotics, we can relieve that pressure and deflect it away from the destabilized joint.
- Shoe guidance. If you’re having trouble finding any pair of shoes you can wear comfortably, we may be able to help you pick out an appropriate pair. Feel free to bring along extra pairs of shoes to the appointment so we can evaluate them.
What Can I Expect From Bunion Surgery?
Let’s say your bunion is severe, and even after several months of conservative treatments, you still aren’t able to live the active lifestyle you want to live without pain. At this point, we’d be looking at surgery as the next recourse.
There are actually several different basic options when it comes to bunion surgery. The most common approach is called an osteotomy, which involves cutting and straightening misaligned bones. Reducing the size of the bunion, removing swollen tissue, and repairing or transferring attached tendons are also commonly performed.
More serious bunions (especially in older patients or those who have had a previous bunion surgery) may require a joint fusion (arthrodesis) procedure.
Of course, we will talk through all your options so that you can make an informed decision about your care. We see every case as unique, and tailor our approach to meet your personal needs.
There are a couple of other key advantages to choosing North Austin Foot & Ankle Institute for your surgery:
- We are trained in minimally invasive surgical procedures using arthroscopy, which may be used for bunion correction in some situations. Because only small incisions are required, you can expect shorter recovery times, lower complication risks, and less scarring when compared to traditional open surgeries.
- We are also trained in aesthetic surgical procedures borrowed from plastic surgery, such as intracuticular sutures, skin flaps, and skin grafts. This further improves the aesthetic result and reduces the appearance of lasting scars.
- Our office provides a variety of regenerative medical procedures, including MLS laser therapy, stem cell therapy, and others. Although these are commonly cited as alternatives to surgery, they can also make great companions to surgery by helping the surgical site and damaged tissues heal faster—not to mention reducing pain.
Full recovery times vary depending on the type of procedure(s) selected, the severity of your original condition, and how well you follow your post-surgical instructions.
We can discuss this with you in more detail at your appointment, but the basic point to remember is this:
If you’re at the point where we’re discussing bunion surgery, it’s fair to say that your condition is severely affecting your day-to-day life. While no one “enjoys” surgery, a few weeks to a few months off your feet is, in our opinion, a very small price to pay for getting your life back!
Did we answer your questions?
We hope you found the above blog helpful as you learn more about your condition and what to do about it.
If you have any further questions, or you’d like to book an appointment with us for an evaluation, please feel free to call our offices at (512) 593-2949. We have convenient locations in Cedar Park and Round Rock to serve you.