Bunions: Causes, Symptoms and Treatments

Updated 9/30/2018

 

Dr. Baravarian discusses bunion causes and treatment options.

A bunion typically appears as a bump on the inside edge of the foot, where the innermost bone of the foot meets the big toe. The bump appears when the first metatarsal shifts outward so that the head of the bone protrudes on the inside of the foot near the big toe joint.

If you suffer from bunions, you’re in good company (although it may not feel like it by the end of the day).

 

Bunions are one of the most common foot problems, affecting an estimated 25-33% of adults. Bunions occur the most in women and older adults.

What Causes Bunions?

If you suffer from bunions, you’re in good company (although it may not feel like it by the end of the day). Bunions are one of the most common foot problems, affecting an estimated 25-33% of adults. Bunions occur the most in women and older adult. While it may be impossible to determine the exact cause of your bunion, common causes include:

  • Bunion Surgery, Lapidus Bunionectomy, University Foot and Ankle Instiute

    Genetics:

    You may just predisposed to developing a bunion. You may have inherited flat feet or loos ligaments, both of which can contribute to bunions.

  • Structural abnormalities: 

    Missing bones, flattened arches, short first metatarsal, asymmetry of the legs or a foot injury may all result in the development of a bunion.
  • Pregnancy:

    Relaxin, the hormone that helps widen the pelvis during pregnancy, can also soften the ligaments in the foot causing the bones in the feet to spread out and arches to fall. This can result in bunions.
  • Wearing "Bad" or "Improper" shoes:

    High heels can cause tight calf muscles resulting in load-bearing to front of the foot and gradual arch collapse. Additionally certain shoes, such as pointy shoes, can force your foot into an unnatural position.


All bunions are not the same. Some are just a small bump and do not hurt, but others can be a large bump that misaligned the toes and cause terrible pain. 


Bunions are Categorized as Mild, Moderate or Severe. Here's what that looks like.

 

Mild Bunion

 

Bunion Treatment and Surgery Los Angeles
Mild bunion deformity

Technically, you can only “fix a bunion” with surgery, but many patients don't need it to get symptom relief. In its early stages, the progression of the bunion deformity can often be dramatically slowed. Removing pressure from the bunion area and balancing the tendon and ligament alignment are the primary goals of mild bunion treatment. For example, it is important to wear shoes that have sufficient room in the toe area to accommodate the bunion ─ that means softer leather shoes to mold to the deformity and platform type heels for better foot and arch support.

 

Your doctor may also advise the use of pads to protect the bunion from shoe pressure. Customized shoe inserts, called orthotics are made exclusively for your foot and are often used to correct the alignment of the arch and big toe joint. In some cases, physicians also use anti-inflammatory creams around the bunion.

 

Read about UFAI manufactured custom orthotics.

 

 
Moderate Bunion

 

Bunion Surgeon Los Angeles
Moderate bunion deformity

A bunion is considered moderate when it pushes against the second toe. In fact, over time, the big toe can force itself under the second toe, causing it to buckle and form a "hammer toe."

 

If non-invasive treatment is not effective, and the joint is still causing discomfort, the doctor may suggest a bunionectomy to realign the big toe. With this procedure, the bunion head is moved over realigning the angled great toe joint back to a normal position. The tendons and ligaments are also balanced for a more normal pull on the toe.

 

In moderate bunion cases, you will experience a relatively rapid recovery. The procedure allows for immediate weight on the foot in a boot and return to tennis shoes in about a month. The choice of procedure best for each patient depends on the deformity size, the stiffness of the 1st metatarsal and the ease of realignment of the 1st metatarsal during the clinical exam.

 

Learn about the different bunion surgeries performed by UFAI's bunion specialists.

 

 

Severe Bunion

 

Bunion Surgery Los Angeles, Univeristy Foot and Ankle Institute
Severe bunion deformity

In severe hallux valgus bunion cases, the first long bone (metatarsal) in the foot dramatically shifts away from the second metatarsal, resulting in looseness and a large deformity.

In severe bunion corrections, a surgery known as the Lapidus procedure realigns the first metatarsal into its natural position. Using screws, the surgery holds the bone stable so it does not shift again and reduces the change of the bunion returning to basically none.

 

Surgery may also involve removing the enlarged portion of the bunion region, cutting and realigning the bone, and correcting the position of the tendons and ligaments.

 

By using a special plate with Lapidus procedures, our patients are able to put weight on their foot after only 2-3 weeks, rather than the typical 6-8 weeks.

 

Is Surgery the Only Treatment Option for Bunions? Yes and No.

 

UFAI patient Barbara shares how bunion surgery has changed her life.

Unfortunately a bunion never goes away on its own and you can only “fix” a bunion with surgery. But there are a number of non-surgical treatments that may help relieve the painful symptoms of a bunion..

 

Our doctors are big believers in our patients trying non-surgical options, whenever possible.  Luckily there are a number of options when it comes to conservative bunion care. These include:

 

  • Wearing wider shoes and well fitting shoes that don't crowd your toes
  • Use orthotic inserts (known as "custom orthotics" )
  • Try stretching exercises to reduce pressure on the joint of the bunion.
  • Avoid high heel shoes.

  • Have your shoe (or shoes) "stretched" to give your bunion(s) more room

  • Try using a "bunion pad" in your shoe(s) to protect the bunion from constantly rubbing on the shoe.

  • And more, click here to read more about non-surgical bunion treatments

 

If conservative bunion treatments do not work, it's time to discuss surgery with a highly qualified and experienced foot surgeon.

Years of research and experience has proven that no one bunion surgery procedure works for everyone... far from it. Yet the vast majority of bunion surgeons perform just one procedure for all of their patients. 

Unfortunately this leads to a lot of bunion surgery failures. How do we know? Because almost 25% of our bunion surgeries are fixing other doctor's work, which is terribly sad becasue the patient needs to go through yet another surgery.  

 

UFAI is one of the few practices in the world that is trained in all 44 variations of bunion surgery.

 

 

It’s our experience and expertise with the different bunion surgeries that allows us to determine the very best option for each individual patient. This means the quickest, most comfortable, pain-free and successful surgery available.

 

Read more about the types of bunion surgery available at UFAI.

 

 

For well over 15 years, UFAI has been nationally recognized as a Bunion Surgery Center of Excellence

 

We work with manufactures in the development of surgical products and appliances and always are conducting studies to advance the state-of-the-art technologies used in bunion surgery. Currently we are studying the relevance of bone marrow infusion and gelling techniques for several types of bunion surgeries including the Lapidus Procedure.

 

Our surgeons are often asked to share their experience and expertise. They have published dozens of articles and case studies in many scientific journals, including Podiatry Today and Clinics in Podiatric Medicine and Surgery. They are regularly invited to lecture at The American College of Foot and Ankle Surgeon and Western Podiatric Medical Association conventions, as well seminars around the world.

 

 

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