All Your Bunion Questions, Answered
"Bunion" is quite possibly the unsexiest word in the English language, and bunions themselves aren't exactly a joy to deal with. But if you're dealing with the common foot condition, rest assured that there are various ways to find relief and prevent it from getting worse. Here's everything you should know about bunions, including what causes them and how to treat bunions by yourself or with the help of a doc.
What Is a Bunion?
Bunions are pretty recognizable — a bump forms by the base of your big toe on the inner edge your foot, and your big toe angles in toward your other toes. "A bunion develops because of a pressure imbalance in your foot, which makes your toe joint unstable," explains Yolanda Ragland, D.P.M., podiatrist and founder of Fix Your Feet. "The bones of your big toe begin to shift and angle toward your second toe. Constant pressure causes the head of your metatarsal (the bone at the base of your toe) to become irritated, and it gradually enlarges, forming a bump."
Bunions aren't just an aesthetic thing; they can also be uncomfortable and even super painful. "You may experience pain, swelling, and redness around the affected joint," says Ragland. "The skin may thicken and become calloused, and your big toe may angle inward, which can bully the lesser toes, affecting them as well. The big toe may even overlap or tuck under your other toes, resulting in corns or calluses." Like calluses, corns are a thickened rough area of skin, but they're smaller than calluses and have a hard center surrounded by inflamed skin, according to the Mayo Clinic. (Related: The 5 Best Products for Foot Calluses)
What Causes Bunions?
As mentioned, bunions are caused by a pressure imbalance in the foot. Research suggest that, in a foot with bunions, there's a transfer in pressure from the big toe to the other toes, which over time can push the bones in the joint at the base of the big toe out of alignment, according to the American Academy of Orthopaedic Surgeons. This joint then gets larger and protrudes from the inside of the forefoot, often becoming inflamed.
Contrary to popular belief, bunions are not caused by lifestyle factors like wearing certain shoes. But some lifestyle factors can make existing bunions worse. "Bunions are caused by nature, as they're genetically inherited and can progress more rapidly over time because of nurture, such as the use of improper shoes," says Miguel Cunha, D.P.M., podiatrist and founder of Gotham Footcare. As with other physical features, your parents' foot shapes affect your own. It's possible that people who inherit loose ligaments or the tendency to overpronate — when your foot rolls inward while walking — from either parent are more prone to bunions.
In addition to shoe choice, pregnancy can play a role. When you become pregnant, your levels of a hormone called relaxin increase, according to Ragland. "Relaxin renders the ligaments and tendons more flexible, so the bones they are supposed to stabilize become vulnerable to displacement," she says. And so that sideward lean of your big toe can become even more pronounced. (Related: This Is What's Happening to Your Feet Now That You Basically Never Wear Shoes)
If you're on your feet a lot during your day-to-day activities, that can also exacerbate bunions. "Bunions are especially bothersome to people whose jobs involve a lot of standing and walking such as nursing, teaching, and serving in restaurants," says Cunha. "Exercising, and especially running and dancing, with bunions can be painful as well."
Bunions also tend to progress more rapidly in people who have flat feet or who overpronate, says Cunha. "Walking or running in shoes that lack proper arch support can lead to overpronation, which can in turn contribute to an increased imbalance and structural deformity of the great toe joint," he says.
How to Prevent Bunions from Getting Worse
If you have a bunion, there are a lot of things you can do to help prevent it from getting worse. "Mild symptoms can be addressed conservatively by wearing more comfortable shoes and using custom orthotics [insoles your podiatrist can make for you], padding, and/or splints to support your toe in a more normal position," says Cunha. You can see a podiatrist for specific recommendations, or you can easily find gel-filled pads labeled for bunions at the drugstore (like the ones below). "Topical medications, icing, and stretching exercises can also help alleviate symptoms of pain and suffering," he says. Topical analgesics, such as gels or creams containing menthol (e.g. Icy Hot) or salicylates (e.g. Ben Gay), can offer relief from foot pain, according to Harvard Health.
When it comes to shoes, try to limit your wear time of heels and completely flat shoes, which can both aggravate bunions, suggests Ragland. (Related: The Best Insoles, According to Podiatrists and Customer Reviews)
How to Find the Best Shoes for Bunions
If you have a bunion(s), you should try to avoid any shoes that are uncomfortable as well as poorly fitting shoes that don't offer arch support, says Cunha.
Since exercising with bunions can be painful, you want to choose your sneakers wisely. Cunha suggests looking for a pair with a spacious and flexible toe box, which will allow your toes to move freely and minimize pressure on the bunion. They should have a well-cushioned footbed and arch support to hold the plantar fascia (the connective tissue that runs from your heels to toes along the bottom of your feet) and keep your arch from collapsing and pressing down further than it should, which can aggravate bunions, he says. You also want to look for a deep heel cup which will reduce pressure on your bunion(s) with each heel strike, he says.
The following sneakers have all of the above, according to Cunha:
How to Get Rid of Bunions
All of the aforementioned strategies can help prevent a bunion from getting worse, but bunion surgery is the only way to actually straighten out a bunion.
"Surgery is the only way to correct a bunion; however, not all bunions require surgery," explains Cunha. "The best treatment for bunions depends on the severity of pain, medical history, how rapidly the bunion has progressed, and if pain relief can be achieved with conservative non-surgical treatment." To put it simply, "when conservative treatment fails, surgery is recommended to help correct the misalignment of the big toe joint," he says.
For bunions that are relatively mild but still bad enough to require surgery, treatment often involves an osteotomy, a procedure in which the surgeon cuts into the ball of the foot, realigns the tilted bone and holds it in place with screws. For more severe cases, often a surgeon will also remove part of the bone before the realignment. Unfortunately, bunions can return even after you've had surgery. They have an estimated recurrence rate of 25 percent, according to a study published in The Journal of Bone & Joint Surgery.
Bottom line: No matter the severity of your bunion, you can take measures to prevent bunion pain from getting in the way of your day-to-day. And when in doubt? See a doc.