Everything you need to know about bunion treatment

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We run through bunion treatment options, from shoe stretchers to keyhole surgery.

Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Rhalou Allerhand

If a painful lump has developed on the side of your foot that just won’t budge, you might have a bunion. More than 15 million people in the UK suffer with bunions and they are a common foot problem. Painful bunions can interfere with walking and exercising.

To put your toes at ease, Consultant Orthopaedic Surgeon Dr Andrea Bianchi and Orthopaedic Surgeon David Gordon, reveal bunion common causes, symptoms and the best bunion treatment options, ranging from shoe stretchers to keyhole surgery:

What are bunions?

Bunions are bony bumps that are usually prominent on the inside of the foot by the big toe joint. ‘A bunion, medically known as hallux valgus, is a deformity of the foot that forms around the base of the big toe,’ says Dr Bianchi.

They develop due to repeated pressure on the big toe joint. Eventually, the structure of the bone changes, resulting in a bunion. ‘Bunions are very easy to spot,’ says Dr Bianchi. ‘You’ll know that you are suffering from them when you see a bulging lump on the side of your foot and your big toe leans against your second toe.’

Bunions causes

The three main causes of bunions are genetics, pregnancy and footwear, though certain conditions – like arthritis – are also associated with them. If members of your family suffer from bunions, you have a much higher chance of developing them, says Dr Bianchi.

While anyone can get a bunion, they are more common in women. Women may develop bunions during pregnancy due to changes in hormones, which effectively loosen the ligaments and flatten the feet. Women are also more likely to wear tight, narrow shoes that force the toes together.

‘Tight-fitting shoes can cause bunions, as they put more pressure on the toes,’ Dr Bianchi adds. ‘If you are genetically predisposed to bunions, wearing shoes like this can cause bunions to form at a much more rapid rate. High heels do not cause bunions, but they can exacerbate the problem, as they force your body weight to the front of your foot.’

Bunion symptoms

At first, the bunion bump will be painless. However, over time it can cause the toes to crowd closer together, which can bring about further issues, such as:

  • Your big toe turning towards your second toe
  • Pain and tenderness on the side of your big toe
  • Redness, swelling and inflammation on the side of your big toe
  • Hardened, thick skin on the bottom of the foot
  • A callus or corn on the big toe or second toe
  • Stiffness and restricted motion in the big toe

For many patients, the pain can be particularly bad after wearing tight-fitting shoes such as high heels, says Dr Bianchi. ‘For lots of people, suffering from bunions means that they can no longer wear the fashionable they want to,’ he explains. ‘Some people suffering from arthritis may also experience restricted movement of their big toe.’

When to see a doctor about bunions

Many people with bunions don’t experience any problems at all. ‘Bunions often don’t require any kind of medical treatment,’ says Dr Bianchi, ‘but if the pain is having an impact on your quality of your life, then treatment might be the right option for you.’

If your experience any of the following, book a consultation with a specialist:

  • Continuous painthat is stopping you doing normal activities.
  • Decreased movement of your big toe.
  • Difficulty finding shoes that fit properly.
  • Worsening symptoms.
  • Pain has not improved after trying home treatments for a few weeks.
  • You have diabetes (foot problems can be more serious if you have diabetes).

Bunions treatment options

While you can’t prevent bunions completely, there are a few things you can do to minimise the discomfort they cause and avoid aggravating them further. In most cases, bunion symptoms can be relieved with simple treatments to relieve pressure on the big toe, such as the following:

  • Change your footwear

Wearing wide shoes with padded soles can help alleviate the pain associated with bunions. Opt for a soft, wide shoe without a heel, says Gordon, making sure they don’t compress the toes. Avoid high heels and tight shoes.

  • Try shoe stretchers

Some shoes can be modified and reshaped using a shoe stretcher. This stretches out the areas that put pressure on your toes and increases the width to accommodate the bunion, says Gordon. Buying over-the-counter arch supports to wear in your shoes may also be helpful.

  • Take painkillers

Taking over-the-counter pain relievers paracetamol can help you manage the pain of bunions. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can also alleviate swelling. However, speak to your doctor before taking any painkillers on a longer-term basis (more than 10 days).

  • Apply ice or heat

When the bunion is irritated and painful, try applying heat – for example, soaking in a warm bath or applying a hot water bottle – or ice packs to the area for 20 minutes, several times a day.

  • Use bunion correctors

This includes bunion splints, bunion sleeves, bunion pads, and toe spacers. While they won’t cure bunions, they can help ease some of the discomfort and pain associated with them.

  • Cortisone injections

Steriod injections can relieve pain temporarily by reducing inflammation at the site of the bunion, but they can cause tissue damage when used often and at high doses.

Bunion correctors

The easiest way to ease the pain caused by bunions is by using bunion correctors. These include bunion sleeves, bunion splints, bunion pads, and toe spacers:

️ Bunion sleeves

These bunion correctors are elastic compression socks that cover the entire big toe joint. Designed to be worn with shoes and socks, they cushion the area and protect it from the friction of the shoe.

️ Bunion pads

Bunion pads help to cushion the painful area around the bunion. Often made from silicon rubber with gel inside, they protect the area from rubbing. Make sure you test the pads for a short period of time. If you find they increase the pressure on the bump, stop using them.

️ Bunion splints

A bunion corrector splint wraps around your foot with hinges and velcro straps. It’s designed to gently stretch the toe back into a natural position while you wear it, and can be especially useful post-surgery, while tendons, ligaments and bones are healing. However, a bunion corrector splint cannot heal or correct a bunion. It can only provide pain relief.

️ Toe spacers

These are silicone devices that can be placed between the big toe and the index toe to prevent them from rubbing together. Some toe spacers can be worn inside shoes, while others are designed to be used barefoot at home.

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