A bunion is an enlargement and deformity in the joint at the base of the big toe. This joint, known as the metatarsophalangeal joint or MTP, connects the great toe to the foot. A painful bump forms at the joint, and the skin covering the bunion can become sensitive and red. If left untreated, eventually the tip of the big toe may angle inwards toward the other toes. Sometimes the MTP joint also develops bursitis, which is an inflammation of the fluid sac over the bunion.
The tendency to develop bunions can run in families. Nine out of 10 patients with bunions are women, but men can develop them, too. For some patients with bunions, simply wearing shoes and walking causes pain.
Three main things commonly contribute to bunions: your foot type, how you walk, and what you wear on your feet. People with flat feet or low arches are more prone to developing bunions. A walking gait with abnormal motion, such as excessive pronation — turning the feet outward — may contribute to bunions. Footwear can make a difference, too. Wearing tight or pointed-toe shoes or heels higher than 2 inches can contribute to the development of bunions.
Non-surgical, conservative treatment measures can provide relief from bunions and their pain. Treatment involves protecting the bunion with padding, taping the foot to help with improved positioning, and using functional orthotics to correct an abnormal gait or pronation (an outward turning) of the foot. Anti-inflammatory medications such as over-the-counter oral preparations and prescription injections of cortisone may help, too. Custom orthotics and strengthening exercises can also help slow the progression of bunions.
Choosing the right type of proper-fitting shoe is key to treating bunions. The best bet is a lower-heeled shoe with a wide toe box and instep, softer soles, and a pliable leather upper.
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