Did you inherit your mom’s smile or your dad’s long legs? While there are some pleasant genetic traits and characteristics you may inherit from your parents, chances are you may also inherit some not-so-great ones—such as foot problems, namely bunions.
Bunions (also called hallux valgus) run in families, because foot types, such as shape and structure, are hereditary (thanks, mom and dad!). Heredity is a prime cause of bunions, but there are secondary factors that can contribute to this foot deformity as well. Joseph Dobrusin, DPM, a Banner Health podiatrist in Arizona, explains what a bunion is, how you can help prevent bunions and minimize the effects.
What are bunions?
“Clinically speaking, a bunion is an angulation deformity of the first metatarsal where it drifts away from the midline of the foot,” Dr. Dobrusin said. “Basically, as the first metatarsal drifts away from the midline, the big toe drifts laterally and impinges on the second toe, thus causing the bone to be prominent and poke out.”
While genetics play a factor, wearing tight, narrow shoes or high heels might cause bunions or make them worse. Bunions can also develop as a result of a medical condition, such as arthritis. And to make things worse, if you get a bunion on one foot, you’ll most likely get one on the other foot too.
Signs and symptoms
Signs and symptoms of bunions include:
- A bony bump on the outside base of the big toe joint
- Redness or soreness at the joint of the affected toe
- Hardening of the skin or a callous that covers the bump
- Bunion pain - pain between toes or ball of the foot that comes and goes
- Movement restriction of the affected toe
A bursa, a fluid-filled sac that provides cushioning near the joint of your big toe, can become swollen and painful when the joint enlarges due to a bunion. This condition is known as bursitis. The inflammation can intensify the pain and potentially harm the protective cartilage covering the joint, leading to arthritis.
“Usually a bunion will start out small, but it will usually get worse over time,” Dr. Dobrusin said. “If left untreated, it will become more painful and difficult to walk—affecting balance and gait. It may also cause things like bursitis, hammertoe and metarsalgia.”
The initial treatment of a bunion is typically conservative in nature and may include the following:
- Wear comfortable shoes with a wide-toe box that gives you enough room to wiggle your toes. Avoid narrow, pointy shoes, shoes that are too tight and high heels which put pressure on your feet.
- Use over-the-counter padding and inserts to reduce symptoms and stress on the bunion and alleviate pain.
- Take medication, including nonsteroidal anti-inflammatory drugs (NSAIDs), as needed for pain.
- Your doctor may advise you receive a cortisone injection to relieve swelling.
- Use lamb’s wool or cotton to reduce friction and rubbing.
- Apply ice packs to the affected area to help reduce swelling.
- Purchase a custom orthotic and avoid purchasing a generic bunion splint.
“While these conservative methods may help slow progression and relieve pain, they cannot permanently correct your bunion deformity,” Dr. Dobrusin said. “Eventually, surgery may be required if your bunion is chronic, progressive and impairs your quality of life.”
When it comes to bunion surgery there is no one-size-fits-all approach.
“You get five great surgeons in the same room, and they will each have an opinion on how to treat your bunion because there is no one technique that is best for every problem,” Dr. Dobrusin said. “Bunion surgery is an art and not a science. While there are many different types of procedures, they all follow similar fundamental principles and objectives.”
The reason there are so many different surgical procedures is due to the varying shape and size of bunions. But the goal of surgery is to relieve pain, realign the toe joint and correct any deformities that are causing the problem.
Most surgeries are done in an outpatient setting under local sedation, but the length of the surgery will vary depending the severity of the deformity—whether it’s mild, moderate or severe—and if more than one issue needs to be fixed.
The success of your surgery depends on how well you follow your doctor’s orders post-surgery. Depending on the extent of the surgical procedure that was performed, it could take several months to a year for your foot to make a proper recovery.
“Contrary to what you may read on the web, these type of surgical procedures don’t heal quickly,” Dr. Dobrusin said. “Your doctor won’t have you walking right after surgery like you do with total hip replacements. If you have a job that requires you to be on your feet, you should definitely plan to either modify your work or be out of work for some time, so you have the proper time to recover.”
While we can’t change our genetics, the outlook on a bunion is very individualized. While some people experience worsening pain and deformity, others have no symptoms. It’s important to be mindful of potential symptoms and continue to wear proper footwear that won’t aggravate your underlying health condition.
If are suffering foot or toe pain, visit bannerhealth.com to find a Banner Health podiatrist in your area.