The big toe is composed of two joints. The larger of the two is called the metatarsophalangeal joint (MTP), where the first metatarsal (long bone of the foot) meets the phalanx (first bone of the toe).
Bunions, also known as hallux valgus, develop over a long period of time at the MTP joint. Pressure on the MTP causes the big toe to tilt inward toward the second toe. Over time, the MTP joint gets larger, protruding from the inside of the forefoot and producing a large bump at the base of the toe — a bunion. The bump becomes red, swollen, and painful, making it difficult to find shoes that fit or even to walk. The term "bunion" actually comes from the Greek word for turnip, as the bump usually looks red and swollen like a turnip.
Smaller bunions can develop on the joint of your little toe; these are referred to as “tailor’s bunions.”
At Monroe Foot & Ankle Care in Jamesburg, New Jersey, podiatric physician and surgeon Dr. Elliott Perel and his team understand the discomfort that bunions can cause, and they provide a wide range of treatments to correct the problem. Here’s what you need to know.
The exact cause of bunions is unknown, but they’re likely due to a combination of factors, including:
- Foot stress or injuries
- Inflammatory types of arthritis
- Abnormal bone structure
- Flat feet
- Excessively flexible ligaments
The jury’s out on whether high-heeled or too-narrow shoes cause bunions or whether wearing either merely exacerbates an already existing condition.
Bunion symptoms and complications
In addition to the telltale bump on the inside of the foot, symptoms of developing bunions include:
- Red, inflamed skin over the bump
- Big toe tilts outward toward your other toes
- Thickened skin on the underside of your big toe
- Calluses or corns on your second toe (from rubbing)
- Persistent or intermittent foot pain
- Difficulty moving your big toe, or decreased range of motion
In addition to the pain and swelling in the displaced joint, bunions can lead to a number of complications. The bunion can irritate the fluid-filled sac that cushions the joint, known as the bursa, causing it to become inflamed and swollen and leading to limited movement in the other toe joints. This condition is called bursitis.
Hammertoes are another possible complication. As the big toe pushes against the second toe, it can slip underneath that toe, leading to an abnormal bend in the middle joint. This may cause pain and pressure, and wearing shoes may become increasingly uncomfortable as the top of the bent joint rubs against the fabric.
Metatarsalgia is a third possible bunion complication, where you experience pain and swelling in the ball of your foot from awkward walking.
Can my bunions be corrected?
Absolutely! There are a number of treatments for bunions, ranging from conservative to surgical options.
Most bunion cases are treated conservatively, at least to start, which may include one or more of the following:
- Wear shoes with padded soles
- Wear shoes with a wide toe box
- Wear over-the-counter (OTC) arch supports in your shoes
- Have a doctor pad or tape your foot into a normal position, reducing pressure on the bunion
- Take OTC pain relievers for discomfort
- Ice your toe joint to relieve swelling
None of these treatments cures the problem; they’re designed to reduce discomfort and encourage normal walking.
If you don’t find relief from any of the conservative options, surgery may be required. There are many different procedures used, but they’re all designed to realign bone, ligaments, tendons, and nerves, as well as remove swollen joint tissue, so your big toe (or your little toe if you have tailor’s bunions) can be returned to its proper position. At your consultation, Dr. Perel recommends the best procedure for your particular situation.
All surgeries are performed as outpatient procedures, so you go home the same day. And while full recovery can take up to eight weeks, in most cases you can walk on the treated foot immediately after the procedure.
If you’re struggling with a painful bunion, you need to see a specialist to get relief. Give Monroe Foot & Ankle Care a call at 732-328-6798 to schedule a consultation, or make your appointment online. Your feet will be in good hands.