Are you suffering from a large bump on the side of your big toe? Perhaps you noticed that this bump started out fairly small but has gotten worse over time. You very likely have a bunion.
You may have wondered why you have bunions. Is it just bad luck or is something else going on?
Are Bunions Genetic?
While bunions are not hereditary, you can inherit a foot structure that often leads to them. Most notable are flat feet, but foot injuries, neuromuscular problems, and pronated feet can also contribute to their formation. In addition, wearing shoes that are too tight, high heels, and shoes with a narrow toe box can all contribute to the progression of bunions. It is estimated that bunions occur in 33 percent of the population in Western countries..
How Do Bunions Form?
Bunions form when the big toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe.
The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists. Bunions can also lead to other toe deformities, such as hammertoe.
With a bunion you can see on X-ray that the big toe is moving towards the second toe. In addition, you'll notice the first metatarsal separates from the second metatarsal. Without any bone formation, a bump begins to form on the side of the joint.
In addition, the first segment of the great toe and the metatarsal behind it often become hypermobile. As this happens greater and greater separation occurs between the first and second metatarsal causing the toe to drift over.
Let's compare this to your hand. Unlike the great toe, mobility is necessary or you wouldn't be able to touch your thumb to your little finger. If you make a fist with your right hand you'll notice a bump where your thumb knuckle protrudes out. Unless you plan to write with your feet, you don't need that hypermobility.
The hypermobility comes from the tendency of the foot to pronate as mentioned earlier. It's this hypermobility that causes the great toe to drift over toward the smaller toes.
What Causes the Pain?
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
If you lived in a place where the weather is always warm bunions would not be much of an issue since you could accommodate them with a pair of sandals. In a place like Seattle this is a much bigger problem as we need shoes almost all year long. Unfortunately, most shoes are not designed to accommodate bunions.
Can I Have A Bunion Near My Pinky Toe?
While the majority of bunions occur next to the big toe there is one type of bunion that develops next to your pinky toe--a Tailor's Bunion or a bunionette. Why Tailor's Bunion? Long ago when tailors sat cross-legged all day the outside edge of their feet rubbed against the ground. This led to the bump that is now their namesake. Although we are no longer cross-legged tailors we can inherit the structural abnormality that leads to developing this condition. The bone on the side of the little toe moves outward while the toe moves inward causing the bump. Sometime the bump is actually a bone spur.
Conservative Treatment for Bunions
Because they are bone deformities, bunions and Tailors bunions do not resolve by themselves. The goal for bunion treatment is two-fold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement.
Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to footwear designed to accommodate the bunion and not contribute toward its growth (see blog link below for more information).
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
You might wonder if you're a candidate for bunion surgery. Here at the Foot and Ankle Center of Lake City we believe in use conservative measures well before we ever consider surgery, as all surgery come with risks. However, we do recommend surgery when all other treatments have failed to provide pain relief or prevent progressive damage for that patient. In addition, bunion surgery or a bunionectomy may be the best option for patients who feel they can't ever have the quality of life they seek without it. Learn more about bunion surgery and how to determine if it's time to go that route.
While you can't prevent bunions, you can prevent them from getting worse by making better shoe choices.
Choose A Lower Heel Height
Lowering your heel height will make a big difference in stopping the progression of bunions. Higher shoes place more pressure on the ball of the foot and the forming bunion. Lower heels relieve that pressure. Choose shoes that are one inch or lower.
Choose A Wider Toe Box
Choosing a wider toe box will prevent the toes from cramping and relieve pressure on the ball of the foot.
Choose Shoes With A Closed Back
Open back clogs or slides are very popular; however, they are the wrong type of shoe if you have bunions. When your foot is not in a securely fittng shoe, more pressure is applied to the front of the foot. Keep open backed shoes for home, not for walking.
What Patients Are Saying About Bunion Surgery at the Foot and Ankle Center of Lake City
"I had both bunions removed with surgery and Dr. Berg did a fantastic job........more"
For more information about bunions and related problems:
- How to Treat Your Teens Bunions
- Desperately Seeking Stylish Shoes Without Bunion Pain
- 3 Hacks to Keep Your Bunions From Ruining Your Summer
Call us today at 206-368-7000 for an appointment! You can also request an appointment online.