What are the treatments for bunions on the feet?

Bunions are painful enlargements on the medial side of the big toe joint in the foot. They are associated with a deviation of the big toe laterally which is called hallux valgus. They are generally due to a hereditary predisposition and the wearing of footwear that is not big enough for the foot. Bunions tend to be painful because of pressure from the shoes and from damage inside the joint.

The first option to deal with a bunion is to get the correct fitting footwear so that there is no pressure on the enlarged bone. This is crucial as it will help with the symptoms and will help with stopping or slowing the progression of the bunion so it does not get worse. The use of the right shoes is important to prevent this in the first place. Padding around the enlarged bone to stop the shoe from putting pressure on it can also be used to help with the symptoms. The pads will help with the pressure on the enlarged joint, but often do not. Strapping is sometimes used to try and get some correction in the angle of the toe, especially if the pain from inside the joint is more acute and needs to settle before other options are considered. There are some exercises that often help that get prescribed to help keep the joint mobile and flexible. This is useful for those who have more pain inside the joint.

Another option are the bunion correctors which are a split that are supposed to hold the toe in its correct position. Bunion correctors need to be worn at night and the evidence is that they can lead to a small improvement of the angle of the big toe after several months of use, which is a lot of work for a small gain. However, the bunion correctors do tend to be very effective at reducing some of the pain that is associated with damage inside the big toe joint.

The only way to actually get rid of bunions is with surgery. The surgery that is needed for bunions can be quite complicated. It is further complicated by the foot being a weight bearing part of the body so there can be quite a bit of disability in the short-term following surgery. There are many different surgical options that range from just having the lump of the bunion taken off to a major reconstruction that can involve surgical repositioning of several bones to try and correct the hallux valgus. The complexity of the surgical procedure will determine how much rehabilitation is required after the procedure. The decision as to what procedure is done will depend on which structures are involved in the bunion deformity and the preferences of the surgeon as most people have a lot of individual variability in the nature of their bunion. The other thing to keep in mind with the surgery is that the bunion can still happen again if the cause of the bunion is not removed, which will usually involve wearing appropriately sized footwear.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.