Got bunions? Here are 6 things you should know

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Got bunions? Here are 6 things you should know

The word “bunion” is Greek for turnip. And yes, this red, swollen bump at the base and side of your big toe can look like an unsightly root vegetable. More importantly, a bunion can be painful, making it difficult to wear shoes, walk, and stay active, Northwell Health. The condition can drain the fun out of life for the one in three people over 65 with bunions — and for anyone younger who develops this uncomfortable issue. It’s important to treat bunions quickly as they can progress, raising your risk of arthritis, bursitis, hammertoes (tight tendons that make your toes curl downward, hammer-like), and other painful problems.

Fortunately, there are plenty of ways to manage bunions. Depending on the severity of your problem, the approach may be surgical or nonsurgical; if you need an operation, there are multiple methods — including minimally invasive surgery. “See a doctor if you notice a bump on the side of your big or little toe, especially if it is painful,” says Northwell orthopedic surgeon Adam Bitterman, DO. “We can take steps to keep the bunion from worsening or, if necessary, perform a procedure to realign the bones.”

Here are six things foot specialists want you to know.

What causes bunions?

That bump at the base of your big toe is the result of shifting bones, tendons, and ligaments in your foot. Most often, bunions occur after years of excess pressure on your MTP joint (short for metatarsophalangeal joint) — the joint where your big toe meets the rest of your foot. The pressure can push the bones of your big toe in toward your other toes and leave the joint sticking out. You may see a knob-like bump where the joint angles outward, and the skin over it may be red and sore. The same thing can happen on the pinkie toe side of your foot, where a bunionette — also called a tailor’s bunion — can form in the joint at the base of the little toe.

An estimated seven in 10 people with bunions have a family member with the same problem, probably because certain heritable foot shapes or bone structures increase the risk.

But footwear also plays a role — especially if you’ve got those vulnerabilities. Shoes with a narrow toe box or elevated heels can smoosh toes together and contribute to the inward shift of the big or little toe.

A habit of wearing high heels is one reason women are more likely to get bunions, but it’s not the only explanation. Higher estrogen levels can relax connective tissue, making toe joints less stable and more susceptible to the toe-squashing effect of footwear.

What do bunions feel like?

Bunions produce swelling; in severe cases, the pain and stiffness this causes can even make it hard to stand and walk. The rubbing of your shoe against the bump may also make movement painful.

How are bunions treated?

Happily, not all bunions are painful. And if you experience mild discomfort, you may find that nonsurgical treatment provides relief and can prevent the condition from getting worse.

Bunion treatment at home

If your bunion isn’t too severe, your doctor may recommend these steps to keep it from getting larger or more painful.

• Choose shoes with a wide toe box or open toe area.
• Try a toe spacer. These come in various styles, but like the separator used after a pedicure, they can prevent toe crowding.
• Place bunion pads or cushions on your foot or inside your shoes to minimize pressure and friction.
• Use orthotics for bunions, like arch supports or shoe inserts.
• Wear a bunion splint at night to keep the misaligned toe in a straighter position.
• Take over-the-counter anti-inflammatory medications to ease pain and swelling.
• Ask your doctor about a steroid injection to reduce swelling and inflammation.

What is a bunionectomy, and when do I need one?

If nonsurgical therapies aren’t adequate and foot pain is impacting your quality of life, you may need bunion correction surgery (also called a bunionectomy) — the only way to get rid of a bunion.

Bunionectomy brings the toe joint back to its correct position by realigning bones, ligaments and tendons. Keep in mind that although surgery may improve how your foot looks, it’s not a cosmetic procedure; its goal is to relieve pain and restore mobility.

“You should only consider bunion surgery if foot pain affects your life and other treatments don’t help,” Dr. Bitterman says.

Just as your foot needs a specific shoe size, you’ll need an individualized approach to surgery for bunions, notes Dr. Bitterman.

Corrective surgery often involves inserting pins and screws into bones to realign the toe joint. It may also require shaving and reshaping bones, fusing joints together, and using plates to keep them stable. The procedure is relatively quick — it typically takes 30 minutes to an hour — and patients generally go home the same day.

Minimally invasive bunion surgery

When possible, Northwell orthopedic surgeons take a minimally invasive approach to bunionectomy, using tiny instruments inserted through small incisions about the size of a pen tip. This minimally invasive procedure tends to be less painful and may help speed healing.

How long does bunion surgery recovery take?

Thanks to surgical advancements like minimally invasive procedures, many people who have bunion surgery are able to resume their normal activities more quickly than ever. But recovery time varies, depending on the surgical treatment and other factors.

Some people can begin partial weight-bearing exercises two weeks after surgery and are back to wearing regular shoes within six weeks — but most need to keep their weight off the foot and wear a protective boot or orthopedic shoe for up to three months. A complete recovery and return to activities may take up to four to six months.

Do bunions come back after surgery?

A bunion can reemerge if an operation doesn’t correctly realign the bones or if you don’t follow post-op instructions. (And you can always develop a bunion or bunionette on the other side of the foot — or on the opposite foot.)

But surgery to reposition the toe joint can get rid of a bunion for good. Just be sure to see a foot specialist who has the experience and training to provide the right treatment for your specific problem.

This story was produced by Northwell Health and reviewed and distributed by Stacker.