Bunion Care at Aspen Orthopedic Specialists

Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment, thinking that the treatment options available may be more painful.

What Is a Bunion?

A bunion (also referred to as hallux valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment—producing the bunion’s bump.

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

A bunion may start as a cosmetic concern, but as the deformity progresses it can place increased pressure on the big toe joint and surrounding tissues, leading to pain with walking, standing, or wearing certain shoes. Over time, bunions may also contribute to other foot conditions, including corns and calluses from toe crowding, bursitis (inflammation around the joint), hammertoes, arthritis of the big toe joint, and pain in the ball of the foot (metatarsalgia). Early evaluation can help determine the most appropriate treatment before symptoms worsen.

Diagnosis

Bunions are readily apparent—the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take X-rays to determine the degree of the deformity and assess the changes that have occurred.

Because bunions are progressive, they do not go away and will usually get worse over time. But not all cases are alike—some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Nonsurgical Treatment

Sometimes observation of the bunion is all that is needed. To reduce the chance of damage to the joint, periodic evaluation and X-rays by your surgeon are advised.

In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they will not reverse the deformity itself. These include:

• Changes in shoewear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels, which may aggravate the condition.
• Padding. Pads placed over the area of the bunion can help minimize pain. These can be obtained from your surgeon or purchased at a drug store.
• Activity modifications. Avoid activity that causes bunion pain, including standing for long periods of time.
• Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
• Icing. Applying an ice pack several times a day helps reduce inflammation and pain.
• Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
• Orthotic devices. In some cases, custom orthotic devices may be provided by the foot and ankle surgeon.