A bunion is a bony bump that forms on the side of your foot near the base of your big toe. Pressure on the big toe joint causes bunions to form and push your big toe outward toward your second toe.
Bunions become increasingly common with age but can occur in teens and young adults. Some younger people may not have any discomfort with a bunion. Others may experience pain, redness and swelling that make standing, walking, or going about daily activities uncomfortable.
The good news is that no one has to suffer from bunion pain, says Jason Weslosky, DPM, a podiatrist at Henry Ford Health. “If you have any discomfort from bunions—at any age—see a podiatrist for an evaluation. We offer treatments like specially designed silicone pads and custom shoe inserts to relieve pressure on bunions. For people with more severe symptoms, surgery may be an option. New minimally invasive surgical techniques have transformed care, speeding recovery after bunion removal.”
What Causes Bunions?
Bunions can form for many reasons, but genetics plays a significant role. “If you have a family history of bunions, you’re more likely to develop them,” says Dr. Weslosky.
He explains that genetic conditions affecting how your foot moves (foot mechanics) can also cause bunions. These conditions include connective tissue disorders, flat feet and hypermobility of the toe joints. Rheumatoid conditions like gout and psoriasis can also cause bunions.
Footwear may also be a culprit. “Shoes with a narrower toe box or higher heel put pressure on the big toe joint. Teen girls and women who frequently wear these shoes can develop bunions. However, an equal number of teen boys and men also develop bunions. So footwear is only one factor,” says Dr. Weslosky.
When To See Your Doctor About Your Bunion
Foot health is important for long-term health and mobility. Left untreated, a bunion may worsen, reducing your ability to be active. Bunions may also increase the risk of developing osteoarthritis and chronic pain later in life.
Dr. Weslosky explains that it’s hard to predict whether a bunion will worsen, so it’s best to get it checked out. “Even if you’re young and not experiencing symptoms, a visit to a podiatrist can assess the changes in your foot. Your doctor may recommend monitoring your condition and returning for treatment if you develop symptoms.”
Nonsurgical therapies
The goal of nonsurgical treatment is to reduce pressure on the bunion. Your doctor will begin by evaluating your footwear. “We want to ensure you have supportive shoes with a wide toe box,” says Dr. Weslosky.
Initial treatment for bunions includes these nonsurgical approaches:
- Anti-inflammatory medications like ibuprofen
- Ice packs on the bunion and foot
- Silicone pads placed over the bunion and big toe
- Over-the-counter or custom shoe inserts (orthotics)
- Cortisone injections
“Younger people who benefit from nonsurgical treatments are more likely to be able to live with a bunion long-term,” says Dr. Weslosky. “That’s why it’s important to seek care early when your bunion is more flexible and easier to treat.”
Dr. Weslosky recommends talking with your doctor before using any device promoted to eliminate bunions. “These devices may involve placement of a separator between your big and second toe to realign your foot. However, once the device is removed, the misalignment recurs,” he says.
Surgical therapies for bunions
Foot And Ankle Care At Henry Ford
For people who continue to have pain after trying nonsurgical therapies, bunion surgery (bunionectomy) may be an option. These surgeries are usually performed as an outpatient procedure, so you don’t need to stay overnight. During bunion surgery, a surgeon removes the bunion and realigns the foot.
“Many young people have heard stories from older relatives or friends about long recoveries after bunion surgery. However, recent advances in minimally invasive procedures offer a significantly shorter recovery,” says Dr. Weslosky.
With these procedures, a surgeon makes a series of small incisions and uses specialized instruments to perform bunion repair. After the procedure, you wear a walking boot for two to four weeks before returning to your regular shoes.
Traditional open surgery involves a larger incision and may be recommended for more complex bunion conditions. Recovery can take two to three months, during which you wear a cast followed by a surgical shoe.
After bunion surgery, some young people may develop a bunion again later in life. Nonsurgical treatments and supportive footwear can reduce the risk of a bunion reforming or worsening.
“Every person’s bunion and foot anatomy are different. Talk with your doctor to determine what bunion treatment is right for you,” says Dr. Weslosky. “The earlier you seek care, the sooner you can find pain relief and return to an active lifestyle.”
Dr. Jason Weslosky is a podiatrist who sees patients at Henry Ford Hospital and Henry Ford Medical Centers - Fairlane and Columbus.
