A bunion is a large, bony bump that forms at the base of your big toe—also known as your metatarsophalangeal (MTP) joint. Over time, genetic factors as well as wear and tear can push your big toe out of alignment. As the tip of the toe pushes inward toward the neighboring digit, the MTP joint is forced outward to compensate.

Bunions may start out relatively small, but because they are a progressive condition, they will only get worse until you step in and do something about them. If you intervene early, simple conservative remedies performed at home may be more than sufficient to halt the discomfort. If you wait, surgery may wind up as your only viable option.

Common complications that may occur alongside bunions include hammertoes and painful corns or calluseswhere the first and second toes overlap.

What Really Causes Bunions?

At the fundamental level, bunions form when feet aren’t able to balance forces properly and excess pressure and weight get concentrated in problematic areas. Over time, the MTP joint at the base of your big toe can become unstable and gradually drift out of alignment.

Factors that can contribute to bunion formation include:

• Genetics. Some foot structures do a better job than others at successfully balancing forces. As a result, bunions do tend to run in families. Alternatively, you may have inherited a congenital deformity.
• Shoes. Styles that pinch toes together in a narrow space or throw all your weight on to the front of your feet, such as high heels, may accelerate instability in the MTP joint. This is a big reason why bunions are much more common in women than in men.
• Injuries and arthritis. An acute trauma or repetitive overuse can weaken and destabilize the MTP joint, facilitating bunion development.
• High-impact activities. Occupations or hobbies that place lots of stress on the feet—ballet dancing, for example—frequently lead to bunions.

Conservative Care Options

At the first sign of trouble, schedule an appointment to see the experts at Foot & Ankle Clinic of the Virginias. By intervening early, bunion progress can usually be halted or significantly slowed, and pain can be managed conservatively. At your initial appointment, we’ll assess your bunion and help you put together an ideal treatment plan tailored to your needs.

Conservative treatment options include:

• Shoe modifications. Switch to shoes with better cushioning and roomier toe boxes, or get existing shoes modified to avoiding putting painful pressure on the bunion.
• Padding. Place a bunion pad over the bump to provide protection and reduce friction.
• Taping or splinting. In some cases, your toes may be repositioned into better alignment via the use of tape or splints.
• Injections. Cortisone shots can relieve swelling and pain.
• Physical therapy. Certain stretches and exercises help you strengthen and re-train supporting muscles, tendons, and ligaments to prevent further progression.
• Orthotics. These inserts slip inside your shoes and help your feet better balance weight and pressure, redirecting them away from the MTP joint.

Surgical Correction for Bunions

Although treatment always begins conservatively, sometimes the bunion has progressed too far and the only way to eliminate your pain and discomfort is through surgical correction. If you’ve gotten to the point where you’re having more good days than bad, and pain is preventing you from doing things you normally enjoy—or just accomplishing daily tasks—then it may be time for surgery.

Several different surgical options exist; we’ll select an approach based on the severity of your bunion as well as your personal needs. As necessary, we may remove swollen tissue or bony prominences, realign toes through cutting and repositioning the bones (osteotomy), transfer soft tissues, or select other procedures that your surgeon deems appropriate.

Recovery will take time, and some post-operative swelling and pain is normal. Our team will provide you with a detailed list of guideline to follow to ensure you understand your responsibilities for post-op care. You may be off your feet for 2 months or more, and full recovery can last up to a year, though recovery times can vary significantly based on the severity of the bunion, the type of surgery, your age and your health status. While no one enjoys spending time off their feet, the potential return—years of pain free activity—is often more than worth the temporary setback of surgery.

Bunion Care in Virginia and West Virginia

The podiatrists at Foot & Ankle Clinic of the Virginias are bunion specialists who can help you determine what type of approach will be best for your situation. We are experienced, compassionate doctors who always take the time necessary to listen to your concerns and craft a treatment program tailored to your needs. To schedule an appointment at one of our many convenient locations in Virginia or West Virginia, please call toll free at (800) 456-8637, or call you preferred office directly.