What can be done to help bunions on the feet?

Bunions, medically known as hallux valgus, are a common foot deformity that occurs when the big toe begins to drift toward the second toe, causing a bony bump to form at the base of the big toe joint. This condition often leads to pain, swelling, and difficulty with footwear, impacting daily activities and quality of life. Managing bunions involves a variety of treatment strategies, ranging from non-surgical interventions to surgical options, depending on the severity of the condition and the patient’s specific needs

Choosing shoes with a wide toe box allows the toes to sit naturally without being compressed, reducing the pressure on the bunion. Narrow, pointy-toed shoes can worsen the angle of the big toe, so wearing shoes with a roomy front is essential. High heels place added pressure on the front of the foot, exacerbating bunion pain and deformity. Opting for shoes with low or no heels helps distribute body weight more evenly across the foot. Some shoes come with extra cushioning that provides support around the arch and alleviates strain on the forefoot. In addition, custom orthotic inserts can be beneficial in realigning the foot and reducing pain, particularly for individuals who experience pain in other parts of their feet due to bunions.

Gel or foam bunion pads can cushion the bunion and provide relief from friction, especially in shoes that might otherwise cause irritation. Toe spacers or separators are small devices that go between the big toe and the second toe to gently realign the big toe. While they cannot cure bunions, they can help slow the progression by keeping the toe in a more natural position. Some people find relief from night splints or bunion correctors, which are worn while sleeping to keep the big toe in alignment. This can help stretch the soft tissues around the bunion and maintain a better alignment over time. Strengthening exercises, such as towel curls (using the toes to pull a towel toward you) or picking up small objects with the toes, can help strengthen the muscles surrounding the big toe joint, improving alignment. Stretching exercises that focus on maintaining the mobility of the toe joint can help reduce stiffness and discomfort in the big toe. Gentle stretching of the big toe in various directions can promote flexibility. Working on general foot and ankle strength and flexibility, under the guidance of a physical therapist, can alleviate pressure on the bunion and improve overall gait, reducing the likelihood of further joint strain.

Applying ice to the bunion can help reduce inflammation and numb pain. This is particularly helpful after periods of prolonged standing or walking.Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can temporarily relieve pain and inflammation associated with bunions. There are various anti-inflammatory creams available that can be applied directly to the bunion area to reduce pain and inflammation. Excess weight can increase the pressure on the feet, worsening bunion pain and potentially accelerating the deformity. Maintaining a healthy weight can alleviate stress on the feet and reduce symptoms. Avoiding activities that place excessive pressure on the front of the feet, such as running or high-impact sports, can be helpful in managing bunions. Low-impact exercises like swimming or cycling may be preferable.

For severe cases where conservative treatments fail, surgical intervention may be necessary. Several surgical options exist, ranging from removing the bony prominence (exostectomy) to more complex realignment procedures. A common approach is an osteotomy, in which the bone is cut and repositioned to correct the angle. Recovery from bunion surgery can take several weeks to months. During this time, patients may need to wear protective boots or splints, use crutches, and attend physical therapy. While surgery can be effective, it’s generally considered a last resort after non-surgical methods have been tried.

People with a family history of bunions or who start to notice changes in their foot shape should be proactive in monitoring their foot health. Seeing a podiatrist at the first sign of bunion formation can be helpful in managing it early on. Keeping the feet in good condition by regularly moisturizing, avoiding high heels, and managing calluses or corns can contribute to foot health, potentially delaying or preventing bunion progression. Bunions can be managed effectively through a combination of footwear modifications, physical therapy, lifestyle changes, and, in more severe cases, surgical intervention. By taking preventive steps early and employing non-surgical methods, many people can slow the progression of their bunions and maintain their quality of life without surgery. Those who require surgery, however, often find relief through these procedures, which have become increasingly effective and minimally invasive. Managing bunions is a personal journey, and seeking advice from a healthcare professional, such as a podiatrist, is crucial for developing a tailored plan that best suits individual needs.

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