Foot Care for Bunions (Hallux Valgus)
A bunion (or hallux valgus deformity) occurs when a bony growth develops at the base of the big toe. As the growth becomes bigger, the toe becomes misaligned and starts to lean into the other toes. The second toe often develops into a hammer toe due to impingement from the big toe. The joint between the base of the big toe and the ball of the foot, called the first metatarsophalangeal joint, becomes inflamed and painful. The bursa, which is the fluid-filled sac next to the joint, can also become inflamed, leading to swelling, redness and pain. This condition is known as bursitis.
Although bunions most often develop at the base of the big toe, smaller bunions sometimes develop at the base of the small toe. This is a Tailor’s bunion.
What causes bunions?
Some statistics claim that the ratio of women to men who develop bunions is 10:1. The biggest cause is footwear. More specifically, the shoes in question have a narrow toe box that push the toes together and high heels that put stress on the metatarsophalangeal joints. For more information on the effects of high heels, read here. Heredity can be a factor. Medical conditions that affect the joints, such as arthritis, cause it as well.
Caring for bunions:
Shoes that accommodate the bunion are a must. The toe box should be wide enough to comfortably fit the width of the forefoot and there must be wiggle-room for the toes.
It is never a good idea to cut a hole at the side of the shoe to provide more room for the bunion. A hole in the side of the shoe can irritate the skin around the bunion or cause herniation of the inflamed bursa – ouch!
Padding can be cut to protect the bunion and make walking more comfortable. At McDermott Footcare, I cut special padding specific to the size and location of the bunion that cushions it inside the shoe.
Toe spacers placed between the first and second toes keep them from rubbing against each other and realign the big toe. A bunion brace or splint may be worn at night for realignment.
A person who has bunions often benefits from custom-fitted orthotics. A podiatrist or chiropodist provides this service.
Medical Treatment of Bunions:
The pain and discomfort from an inflamed bursa next to the metatarsophalangeal joint may be relieved by oral anti-inflammatory medication such as ibuprofen. Before taking anti-inflammatories, check with your doctor first if you are taking any other prescription medication. And always take them as directed. Ice packs provide relief as well.
For persistent bunion pain, surgery is an option to discuss with your doctor. An osteotomy realigns the joint. Arthrodesis surgery removes damaged parts of the joint. The most common procedure is a bunionectomy which shaves off the bony growth. This surgery is not always successful and the big toe may return to its deviated position post-surgery.
The best way to care for bunions is also the best way to prevent bunions. Proper footwear is the first line of prevention. A wide toe box, wiggle room for the toes, a low heel; these are what to look for in an everyday shoe (read here for more on shoes and socks). While this advice applies mostly to women, men would do well to use the same guidelines for footwear.
Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author