Pain from a bunion—a deformity that forces the big toe out of alignment—can stop you in your tracks. Yet many people suffer unnecessarily because they don’t know that there are ways to relieve the pain.
The primary cause of bunions is your foot’s structure, says Zachary L. Chattler, D.P.M., a former instructor in the department of orthopaedic surgery at Johns Hopkins University and practicing podiatrist. Bunions occur most frequently in feet that pronate, he says, meaning, as a person walks, the ankle rotates internally and the forefoot rotates externally. Bunions may result, which causes an abnormal pull on the foot’s tendons and bones.
But heredity isn’t completely to blame; shoe choice plays a considerable role. Narrow or poorly fitting shoes, like high heels, can exacerbate bunions by pushing toes into an abnormal position and putting pressure on toe joints.
“That’s why women seek treatment for bunions far more frequently than men, even though both genders develop the deformity," he says. "Shoes won’t cause a bunion, but they can speed up the progress and make it worse."
The first step to alleviate pain is to make sure your shoes fit properly. Trade in narrow, flat shoes or high heels for shoes with wider toe boxes and more support.
Also, make sure you are wearing the correct size. Chattler stresses that many adults think their feet haven’t grown since their teens. In truth, feet continue to get bigger as the ligaments loosen and arches flatten over time.
To test if your shoes are too narrow, stand barefoot on a piece of paper and have a family member or friend trace an outline of your foot. Then place your shoe on top of the outline—if your foot is wider than your shoe, which is often the case with people who have bunions, it’s time to buy new shoes.
You can also ask your doctor about prescribing custom-made orthotics that fit in your shoes and prevent your feet from overpronating.
To temporarily relieve pain and swelling, try nonsteroidal anti-inflammatory drugs, such as ibuprofen. If that doesn’t work, you may need a prescription steroid injection.
For further short-term relief, podiatrist Bruce S. Lebowitz, D.P.M., a former instructor in the department of orthopaedic surgery at Johns Hopkins University and practicing podiatrist, suggests keeping feet elevated and sticking to low-impact exercises like walking, water aerobics, or stationary biking, which will not aggravate the bunion as much as running or other high-impact activities.
Although bunions are permanent, most people find relief through conservative treatments. If not, surgery may be your next option.
A number of procedures can correct the misaligned joint and remove the bump. All bunions are different, says Chattler, so speak with your physician about which procedure is best for you.
Surgery usually lasts about one hour with local anesthesia, and most patients leave the hospital that day. But healing can take eight to 12 weeks, and swelling can last up to six months. Although surgery will relieve bunion pain, bunions can grow back, especially if you continue to wear ill-fitting shoes. So choose the right footwear to stay pain-free.