A bunion is a bony prominence at the inside of the big toe, which is the result of a structural malalignment of the big toe joint.1 In addition to a lump, the bunion causes the big toe to point inward and overlap with the toe next to it.2 Bunions may be considered unsightly by some people, but the real concern is that they can be painful or become painful over time.
Physical symptoms of bunions can include:
Restricted, painful motion of the big toe
Redness over the boney prominence
Calluses (hardened skin) 2
Altered gait (manner of walking)1
When you have a bunion, it can be hard to find shoes that fit right. Bunion pain can significantly impact your ability to do even simple activities.
While bunion surgery is an option, you have many less invasive treatments to try first. Some treatments are aimed at alleviating the symptoms, whereas others are focused on getting rid of the bunion.
Foot and ankle exercises can help correct a muscle imbalance around the joint, which may be either a result of the bunion or contribute to the cause of it.1 Your doctor may recommend physical therapy3 or give you exercises to do at home.
Bunion exercises are broken down into two types:
Muscle-strengthening to get and keep the joint in alignment
Range-of-motion to keep the joint supple and mobile1
Examples of foot exercises include curling the toes, spreading the toes, and heel raises.4
When bunions become painful, oral or injected pain medications may alleviate your pain and lessen inflammation.
Oral non-steroidal anti-inflammatories (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen) may be useful when the bunions are associated with pain, swelling, or redness.5
Injection of corticosteroid medications is another option. Research shows that it can be effective against bunion pain.6
Bunion Pads and Splints
Bunion pads and splints are readily available devices that are placed on the foot to treat the symptoms of bunions or address the structural malalignment.
Bunion pads provide a layer of cushion for the bunion against the shoe to lessen or remove pressure and irritation. They can work well for relieving pain as long as they're not too thick, which can increase the pressure.5
Bunion splints, on the other hand, are intended to actively push the big toe into better alignment. However, a review of studies on bunion treatment found that splints were ineffective both at relieving pain and realigning the joint.7
Shoe inserts are another method to help treat bunions by providing structural support to the foot, which may improve foot alignment and ultimately limit bunion progression.
Bunion-specific orthotics aren't available, but doctors can create prescription orthotics that address your foot type.
Research shows orthotics can be somewhat effective, but, on their own, are generally inadequate and should be combined with other treatments.7
The only method to truly correct a bunion is bunion surgery, which structurally re-aligns the displaced bones.
The procedure most often involves either:
A bunion cut to realign the top (Austin or chevron bunionectomy) or bottom portion of the bone, or
Repositioning the entire bone through a bone mending/fusion procedure at the bottom of the deviated bone (lapidus bunionectomy)8
Depending on your type of surgery, you may need to wear dressings or a brace for six to twelve weeks after the procedure.9 Some surgeries allow for immediate weight-bearing afterward, while with others, you may need to use crutches.10
Be sure to ask any questions you may have to ensure you understand and are able to follow your doctor's instructions about the recovery process.