Bunions are bony bumps that develop on the inner side of the foot at the big toe joint and are associated with a condition in which the big toe moves toward the smaller toes and the outside of the foot.
By shifting the alignment in the foot and crowding the toes together, bunions can alter the mechanical forces in the ball of the foot, leading to pain and stiffness.
Bunions usually develop slowly over time, as the normal position of the bone, tendons, and ligaments change, leading to deformity. As the deformity gradually worsens, it may make it difficult and painful to wear shoes or even walk.
At AllCare Foot & Ankle Center in Arlington and Dallas, Texas, podiatrists Michael Tran, DPM and Riya Vyas, DPM, see many patients who’ve developed bunions and know how uncomfortable just walking can be. That’s why we offer a number of treatment options that will get your feet moving again. We get asked a lot if bunions ever shrink on their own. Here’s what you need to know.
The big toe contains two joints. The larger of the two is the metatarsophalangeal joint (MTP); it’s where the first long bone of the foot (metatarsal) encounters the first bone of the toe (phalanx). Bunions form at this joint.
The problem starts when the bones that make up the MTP joint move out of alignment. Due to external pressure from too-narrow shoes, constant reliance on the joint from activities such as ballet, or simply from genetics, the metatarsal shifts toward the inside of the foot, while the phalanx angles toward the second toe. The result is a protrusion on the inside of the forefoot.
The enlarged joint is often inflamed, from both abnormal mechanics and direct irritation from your shoes. The bunions start out small, but they worsen over time because the MTP joint flexes with every step. The more it flexes, the bigger the bunion gets, and the more painful and difficult walking can become.
An advanced bunion alters the appearance of the entire foot. At this stage, the big toe may angle all the way under or over the second toe. That pressure can force the second toe out of alignment, causing it to come in contact with the third toe, and the third toe with the fourth.
This cascade of pressure can lead to hammertoe deformities in the smaller toes. The mid-joint of the toes angles upward so that the shape of the toe looks like a hammer. This joint can become rigid and painful, causing even more problems with mechanics.
The answer is no, they won’t. The forces at work alter the structure of the foot and its many joints. Once they’ve been pushed out of position, they won’t simply “decide” to move back the other way. You need proper treatment to either restructure the foot, which is very invasive, or find ways to alleviate the discomfort so you can walk normally again.
In most cases, bunions can be treated conservatively, without surgery, and bunions that aren’t painful don’t require treatment at all. While nonsurgical treatment can’t shrink a bunion, it can help reduce pain and prevent further problems. Here are some of the options.
You can often successfully manage bunion pain by choosing proper shoes. They should fit properly, especially in the front, with a wide toe box that won’t compress the toes. If you have shoes that are just a bit too small in the front, you can try using a shoe stretcher to widen the area.
If the motion of the MTP joint causes you pain, a shoe with a slight rocker bottom may be helpful.
Orthotics are custom-made shoe inserts that provide the necessary padding to relieve pressure on the bunion, offer heel and arch support, and generally help the mechanics of walking so you don’t make the problem worse.
A second option is toe spacers, which you wear between your toes to prevent them from pressing on each other and causing them to shift.
A third option is a night splint. You wear it when you go to bed, and it holds the big toe in a straighter position, which may help relieve pain. Splints, however, won’t straighten the MTP joint; they’re used only for symptom relief.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen help relieve pain and reduce inflammation and swelling. If your bunions are caused by arthritis, the doctor may prescribe other medications to help.
If your bunions are causing you pain, there’s no need to endure it; AllCare Foot & Ankle Center can help. To schedule a consultation with one of our podiatrists, call one of our offices or book online with us today.
