A bunion is a painful, bony lump that can develop on the side of your foot and can affect how you walk. And one thing that can increase your risk, is wearing shoes that put a strain on the bones and muscles in your foot; like those narrow, high-heeled ones. It can develop if your big toe starts to angle towards your second toe. Some people don’t ever get any symptoms from them, but they can lead to discomfort and pain.
How Does a Bunion Affect You?
Sometimes the skin over the lump can become red, blistered or infected. A fluid-filled space called a bursa, (which surrounds and cushions the joint), may also develop under your skin, and can be painful if it swells up.
Painful bunions interfere with walking and exercising, but you can prevent them from getting worse. Most shoes don’t accommodate the resulting protrusion, and so put pressure on the misaligned joint. Eventually, the bursa becomes inflamed, and the entire joint becomes stiff and painful. A bunion is most likely to develop when susceptible feet are repeatedly squeezed into narrow, pointed-toe footwear. The big toe pushes against the other toes, sometimes diving over or under them.
While shoes with narrow toes can trigger a bunion, they are not the underlying cause. Bunions run in families, because foot type, (shape and structure), is hereditary; but some types are more prone to them than others. Low arches, flat feet, loose joints and tendons, all increase the risk. The shape of the metatarsal head, the top of the first metatarsal bone also makes a difference; if it’s too round, the joint is less stable, and so more likely to deform when squeezed into these inappropriate shoes.
High heels can exacerbate the problem because they tip the body’s weight forward, forcing the toes into the front of the shoe. This may help to explain why bunions are 10 times more common in women than in men. People in occupations such as teaching and nursing, which involve a lot of standing and walking, are susceptible to bunions. So are ballet dancers, whose feet suffer severe repetitive stress. Women can develop bunions and other foot problems during pregnancy, because hormonal changes loosen the ligaments, and flatten the feet. Bunions are also associated with arthritis, which damages the cartilage within the joint.
The metatarsal joint helps us bear and distribute weight during a range of activities. A bunion at this critical junction of bones, tendons, and ligaments can seriously impair the foot’s functioning. For one thing, not only can a bunion on the big toe damage the other toes, but under the pressure of the big toe, they may develop corns or become bent, forming hammertoes. The nails may become ingrown, and calluses may form on the bottom of the foot. If you constantly shift your weight off the painful big toe joint to other metatarsals, you may develop discomfort in the ball of the foot. As the misshapen joint becomes more uncomfortable, and harder to fit into shoes, you may have to curtail exercise and other activities. Even walking may become difficult.
You may be able to relieve pain and prevent bunions from progressing, with conservative measures that take pressure off the metatarsal joint and improve foot mechanics. Surgery is not a first line treatment option, unless the underlying deformity can’t otherwise be managed, or the pain becomes debilitating despite conservative treatment.
Your first step then, is to relieve the pressure by wearing the right kind of shoe. It’s also important to maintain a normal weight. Shoes should have a wide, flexible sole to support the foot, and enough room in the toe box (the part surrounding the front of the foot), to accommodate the bunion. Some good choices are sandals, athletic shoes, and shoes made from soft leather. Shoes with a back should have a sturdy heel counter (the part surrounding the heel), to keep the heel of the foot snugly in place. You may be able to reshape narrow shoes with stretchers that make room in the toe box for the bunion. Keep heels low, no higher than an inch.
You can also protect the bunion with a moleskin or gel-filled/ silicone pads. Make sure your shoes have enough space to accommodate it. A clinician may recommend semisoft orthoses (shoe inserts), to help position the foot correctly as it strikes the ground. You can also wear a splint at night to hold the toe straight and ease discomfort.
When the bunion is irritated and painful, warm soaks, ice packs, and non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen may help. Ultrasound, and massage may also provide some relief. Cortisone injections can relieve pain temporarily by reducing inflammation, but they have many side effects, especially when used often and at high doses.
Your feet mirror your general health . . . cherish them!