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Trouble Afoot? Dealing with Bunions

August 01, 2020

"If you start developing a bunion, try a few of these options to slow its progress right away."

Bad puns aside, it seems there are a lot of different opinions about feet. Some people find them repulsive, others find them attractive, and many of us spend time with pedicures to keep them looking great. Wherever we fall on that spectrum, we all want to keep our feet healthy and pain-free. 

In today’s post, Dr. Keller Wortham, MD, is addressing a painful condition that affects the feet, called Bunions. We’ll talk about what causes them, what things might make them worse, and what to do about them.

Video Highlights

  • 01:21: What is a Bunion?
  • 02:54: What Causes Bunions?
  • 03:32: Do High Heels Contribute to Bunions?
  • 04:46: Treating Bunions
  • 06:57: Surgical Correction
  • 07:37: Wrap-Up

What is a Bunion?

A bunion is basically an alteration of the metatarsophalangeal joint (also called MTP). This joint is between the metatarsal bones of the foot and the proximal bones of the toes. In layman’s terms, it is at the ball of the foot, where the toes meet the main foot bone. 

Over time, that joint can begin to swell and deviate, so that the toe starts to shift inward, and then the joint itself — or the head of the metatarsal — starts to get larger and protrude outward. It can cause a large protrusion on the side of the foot, and may cause toes to crowd until they become cramped. This condition can be quite painful for people, and it can start to rub on shoes, making walking difficult.

What Causes Bunions?

Unfortunately, doctors are not exactly sure why some people get bunions and other people don't, but they do think genetics play a role. So if there are bunions in your family, that very likely increases your risk of developing one yourself. 

We do know that certain other conditions like rheumatoid arthritis or gout, which are both inflammatory conditions of the joints, can cause bunions to occur more frequently. Outside of these known issues, however, a lot of what causes them is unknown. 

Do High Heels Contribute to Bunions?

While this is a common question, the good news is that just wearing high heels, if you don't have a predisposed genetic condition, will not trigger bunions. This doesn’t mean high heels are good for your feet — they have no arch support, they’re bad for your knees, and they can cause shortening of your Achilles tendons. So there are plenty of reasons to avoid high heels, but the risk of bunions is not one of them. 

It is true, however, that if you have a propensity for bunions, wearing shoes that cramp your toes and don't have good arch support can accelerate it. So, if you're someone with a history of bunions yourself or a family history of bunions, you should probably avoid high heels or any other shoes that don't have arch support or that cramp your toes. Flip-flops, for example, do not have good arch support. So if you are predisposed to bunions, or if one starts to form, you really need to be careful to wear appropriate footwear. 

Treating Bunions

If you start developing a bunion, try a few of these options to slow its progress right away. 

  • First and foremost, wear the proper footwear. Make sure your shoes fit well, so they’re not crowding your feet, and have good arch support cushions. This is especially the case if you start to develop a protrusion on the edge of your foot. If you don’t have proper padding, it can start to wear on your shoe, so that you end up with callouses or painful blisters.
  • The next thing you can do is exercise. We recommend some type of barefoot exercise because you can do it at home. Try something like yoga, Pilates, or plyometrics, which involve jumping and bounding on your feet, because that can strengthen the muscles of the foot and help maintain alignment. 
  • You can also get toe spacers, which you put between your toes to help space them out, widen the foot, and restore proper alignment. 
  • Stretching, or massaging the feet can help correct some of the muscle or tendon tightness that might be putting strain on the foot. 

All of these options may help slow the progression of bunions. If these don’t work, or if the bunions are progressively getting worse despite having taken these steps, then you may have to take steps to manage it. 

This might involve wearing roomier shoes that accommodate for your bunion, and using medications to help with the pain. These can include over-the-counter anti-inflammatories like ibuprofen, or natural inflammation-fighters like Smarter Curcumin. You can also apply ice to the area, just as you would with any swollen or painful joint. You definitely want to make sure you have proper padding, so that you're not aggravating it further as it rubs against your shoe.

Surgical Correction

If all that fails, don't despair — there is surgical correction for bunions. If you end up choosing this option, you’ll likely see a foot surgeon who will more or less shave off the end of the metatarsal head, (kind of the ball of your foot) that started to grow abnormally, and then realign the toe. Many times this will involve putting a pin or some kind of hardware just to keep the foot in line. After that, you will need to be careful about how you care for your feet because you don't want to risk a bunion coming back. 

Wrap-Up

We hope this helps you keep your feet happy! We’re sorry to be the bearer of bad news when it comes to preventing bunions, because some of the risk is just in your genes. The good news is that in and of themselves, high heels do not trigger bunions. So just remember that if you have a propensity for them — a family history, rheumatoid arthritis, gout, or you're starting to develop one — make sure you wear proper footwear, exercise, and stretch. If the pain gets too bad, see your doctor, and look at the options for managing it. Thanks for reading! We will see you next time.

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