What is a bunion?
Bunion is a kind of bony bump that appears on the foot, due to the displacement of a bone called metatarsus.
Bunions are extremely painful and uncomfortable, although they are not usually related to more serious illnesses. One of the main causes of the problem is the use of uncomfortable shoes, especially with high heels and a pointed toe. Therefore, it is usually more common in women than in men.
It can also be caused by other factors, such as diseases that affect the joints or malformation in the bone structure of the patient’s feet.
Treatment, in general, involves the use of orthopedic appliances and changes in the types of shoes that are used by the patient. But, in more severe cases, surgical interventions may be recommended.
There are two different types of bunions, which differ only in relation to the part of the foot on which they appear.
The Hallux valgus or hallux valgus is the most common form of bunion. It is one in which the deformity appears on the big toe. The expression that gives the name to the problem comes from Latin and suggestively means “articulation that jumps out”.
Clinically, it can also be called a bunion of the first metatarsal. Metatarsus is the name of a set of long bones, which are located on the forefoot and offer support to the fingers. The first metatarsal is precisely what provides support for the thumb.
In general, Hallux valgus is characterized by a protuberance, very similar to a protruding bone, which appears in the vicinity of the largest toe, mainly at its base.
Joanete de Sastre
Sastre’s bunion, also known as a tailor’s bunion , is characterized by the appearance of a bony elevation in the region of the little toe. Like Hallux valgus , it tends to appear more frequently at the base of the little finger.
The popular name, tailor’s bunion, is due to the fact that the disease was very common among people who worked in tailoring until, more or less, the beginning of the second half of the 20th century.
That’s because, at that time, tailors used to work sitting on the floor, in the lotus position, placing all the weight of the body on the sides of the feet. This habit caused workers to develop such bunions on their pinkies, and the phenomenon was so common that it ended up baptizing the disease.
But, clinically, the tailor’s bunion is a different name. Your doctor will probably call it a bunionette , a Sastre bunion, or a fifth metatarsal bunion .
In addition to types as to location, bunions can still have two different classifications, according to what caused the problem.
The congenital bunion is one related to the structure of the feet or family history. They are called congenital because, in a way, the predisposition to their development is born with the patient.
Purchased bunions are those that are related to causes that arise throughout life. They can be caused by illness, trauma or simply by the constant use of uncomfortable shoes, for example.
What causes the bump that characterizes a bunion is a displacement of the metatarsus, which, in turn, can be caused by a number of factors.
These factors can be congenital, habitual (that is, that are related to some patient’s habit) or pathological (that have a nature in some other disease or disorder).
Structural predisposition of the foot
Some people are already born with a predisposition to develop bunions, due to the natural structure of the foot, which can favor the appearance of the problem.
Any small alteration that interferes with the stability of the foot during the step can increase the pressure on the joints of the phalanx – a bone that is close to the metatarsus – causing the appearance of bunions.
That is why bunion development is very common among people who suffer from problems such as:
- Supinated stepping, when the person steps crooked, with the feet turned out;
- Pronated step, when the person steps crooked, with the feet turned inwards;
- Flat foot, a type of structure in which the foot does not have a plantar arch, a part that remains on the sole and is responsible for providing support to the body;
- Cavo dig, a type of structure in which the plantar arch is exaggeratedly arched, which causes the patient to lose a significant portion of the ability to balance and distribute weight between the feet;
- Knee cartilage problems and wear.
The appearance of bunions is linked to the patient’s genetic predisposition. A survey by the Framingham Foot Study, an American institution specializing in foot research, collected data among 1,370 adults who were diagnosed with bunions and concluded that the disease is closely linked to family history.
Therefore, if you have accompanied your parents or grandparents suffering from bunions while growing up and now suffer from your own bunions, it is important to take this information to the doctor at the time of the consultation.
Wearing unsuitable shoes
Most patients with bunions are female, for a simple reason: women, for sociocultural reasons, are more likely to wear tight and uncomfortable shoes, especially models with high heels and pointed toes.
The design of shoes with heels causes the foot to slide forward, remaining in a curve that, anatomically speaking, causes a lot of discomfort to the bones that make up that part of the body. The fingers, in turn, end up receiving most of the pressure and weight from the body at each step. This process facilitates the appearance of deformities.
Footwear with a pointed toe is even worse, as it narrows the space for the tip of the feet, causing the toe to be pushed until it is superimposed on the second toe. This is the perfect setting for a bunion to emerge.
Arthropathies usually cause pain, stiffness in the joints and, in some cases, deformities. Therefore, bunions are often common consequences of this type of disease.
Some neurological diseases, such as cerebral palsy , brain injuries and strokes can cause a phenomenon called spasticity .
Spasticity causes the body’s muscles and joints to become stiff and tense, with sporadic spasms that are too violent for the region in which they occur.
This process can eventually cause bone and joint deformities through the weakening of tissues, which happens precisely due to the pressure of the spasms. There, one of the consequences may be the appearance of bunions.
Injuries are considered to be rare causes for the appearance of bunions, but it can happen. Generally, the traumas that originate the problem are those that reach a region of the foot called the first ray , which corresponds to the first metatarsal and its two phalanges:
- the distal phalanx, a bone that is at the tip of the thumb;
- the proximal phalanx, the bone that makes the connection between the metatarsus and the distal phalanx.
The traumas that can cause bunions are usually sprains, injuries that reach nerve endings and fractures in general.
Dysmetry of the lower limbs
To say that someone has lower limb dysmetria basically means to say that that person has a longer leg than the other. The problem is usually congenital.
People with dysmetria of the limbs tend to concentrate a greater weight on the longest leg when walking. This uneven division between the legs tends to cause bunions to develop on the foot that receives the greatest weight load.
Anyone who goes through the situations or has the aforementioned habits and illnesses is at risk of developing bunions. Therefore, the risk groups for bunion development are:
- People who wear high-heeled shoes;
- People who wear tight shoes;
- People with diseases that reach the joints;
- People with congenital problems in the formation of the feet;
- People who have more than two cases of bunions in the family, since, in this case, the frequency of events suggests a genetic tendency to the problem.
Bunion symptoms are very characteristic, and essentially affect the affected area. Are they:
- Swelling in the area of the thumb or pinky, similar to a lump or callus, with hard consistency;
- Localized redness;
- Constant pain in the area of the thumb or pinky, which intensifies when walking, stepping on the floor or putting on shoes;
- Stiffness in the affected finger that worsens over time;
- Intensification of the deformity, reaching the point of the finger to appear totally crooked;
- Appearance of small calluses on the soles of the feet or near the toe affected by the bunion;
- Thick, dry skin under the thumb;
- Episodes where the finger affected by the bunion suddenly heats up.
The diagnosis of a bunion is made directly in consultation with your doctor, and the specialty most suitable for treating bunions is orthopedics .
After palpating the area, observing and asking a few questions, the doctor will probably order an X-ray of the affected foot. In some cases, the professional may also order an MRI to confirm the diagnosis.
Gouty arthritis x bunion
It is very common for people with gouty arthritis in the early stages to mistake the disease for a bunion episode.
Better known as gout , gouty arthritis is an inflammatory disease of the arthropathies family, that is, it affects several joints in the body.
The differential of gout in relation to other arthritis is that it affects only one joint at a time, making the patient think that it is a temporary localized pain, or that the pains that they feel in different joints are not related.
One of the joints most affected by gout is the big toe. During crises, the region can become hot, red, swollen and sensitive, typical of bunion symptoms.
The pain in cases of both diseases is also very similar, with intensity ranging from moderate to very strong, constant with throbbing episodes.
In order to differentiate the two diseases, it is important to note that gout manifests itself through crises: the episodes of pain last for some time, then disappear completely, to return a few weeks later. In some cases, gouty arthritis can also cause fever , a symptom that does not exist in the case of the bunion.
So, even if the bunion appears to be a relatively harmless problem, it is very important to see a doctor to be sure of the diagnosis.
Bunion is curable , and in most cases, treatment is simple and effective. More complex conditions, however, may need minor surgical interventions to be resolved.
Conservative treatment is, basically, a purely therapeutic treatment modality, which has the potential to solve the problem without major interventions or prescription of specific drugs to solve the bunion problem.
Some measures used in conservative treatment are:
The first recommendation of the orthopedist will possibly be the immediate suspension of the use of shoes that may be worsening or even causing bunions.
Shoes with heels, a pointed toe, tight or without shock absorbers are likely to be suspended until treatment is complete (for more information, read the subsection “Caring for the choice of footwear”).
The drugs indicated during bunion treatment do not have the function of eliminating the problem, but rather, to reduce the patient’s pain.
Painkillers are prescribed so that the person with a bunion can have a better quality of life while treating the disease. The orthopedist can prescribe medications such as ibuprofen and paracetamol , for example, in doses corresponding to the complexity of your case.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Your doctor may recommend orthopedic insoles, which are slightly different from those that already come inside your shoes when you buy them in stores.
The insoles for bunion are prescribed by the orthopedist who, after an analysis, will recommend the most appropriate model to correct your posture, relieve the impact of stepping on the joints of the feet and bring a little more comfort, avoiding pain.
They can be made to measure and in different materials, mainly silicone and gel. The ideal insole for your case will take into account what exactly is causing the bunions.
The price of the insole varies according to your number of shoes, needs, necessary corrections and material in which it will be produced. In online stores, values ranging from R $ 17.00 to R $ 155.00 can be found.
Also called a toe separator, it is a small accessory made of silicone, made to fit into the space between the thumb and the second toe.
The purpose of using the finger retractor is to avoid the deformity caused by bunions, in which the thumb begins to lean towards the second finger. The expectation is that, with the measure, the patient’s pain will decrease considerably.
Generally, the toe retractor is used as a palliative treatment, as it does not guarantee the disappearance of the bunion without changing other habits – such as the suspension of the use of high-heeled shoes and pointed toes, for example.
In online stores, it costs, on average, from R $ 19.00 to R $ 25.00.
Corrective splint for bunions
Bunion splints – also known as bunion orthoses – are splints produced in acrylic or silicone, created to be flexible, with Velcro closure and adjustment. They have support for the soles of the feet and a space for the perfect fit of the toe.
The purpose of using a corrective splint is to reduce the pain and pressure on the bunion, which should regress with the use of the accessory.
Generally, this type of accessory is prescribed by the orthopedist for night use. It is more common that it is recommended for children, since its effectiveness is more guaranteed on the feet of the little ones, who are still in formation.
In virtual stores, the splint for bunions costs, on average, R $ 60.00.
Use of plasters
The orthopedist may recommend the use of surgical tape, such as micropore tape, to realign the bones of the foot. As it prevents the development of the bunion and decreases the pain.
For this, it will be recommended that the patient place the foot in the correct position and keep it in place by rolling a few layers of tape daily. This type of treatment usually lasts from one to two weeks. Some doctors prefer the patient to visit the office every 2 or 3 days to ensure that the micropore tape is being placed in the right way.
It is important to remember that home treatments do not have scientifically proven efficacy, and should not replace the official treatment recommended by a doctor.
Some ways to treat the bunion at home and / or with the aid of natural products are:
Dip your feet in warm water
The warm water promotes muscle relaxation, relieving pain and increasing the mobility of the feet. For those with bunions, the recommendation is to fill a basin and soak your feet for half an hour, once a day.
Making ice packs
Ice is responsible for decreasing localized swelling and blood flow in the region where it is applied. Therefore, although they do not solve the problem of the bunion itself, the compresses are excellent for relieving pain.
To obtain the desired results, it is important not to apply ice to the bunion area for periods longer than 20 minutes. Make the compress at least once and at most four times a day.
Lavender oil has analgesic and anti-inflammatory properties, and is therefore a very popular home remedy for the treatment of bunions.
You can buy lavender oil at health food stores, or make the product at home.
There are several ways to make homemade lavender oil. The simplest is to heat, in a pan, some fresh lavender flowers with a little bit of almond oil or olive oil, in a water bath.
Then strain the mixture to obtain the oil, return to the fire and repeat the procedure two or three more times. Then, just store the product in a pot and leave it in a place protected from heat and moisture. Apply to bunions every night before bed.
If you experience any type of allergic reaction, such as itching or redness, stop using it immediately and consult your doctor.
The essential oil of white lily is known to relieve pain in muscles and joints, and can be purchased in health food stores. To use it, just apply a few drops on the bunion once a day and massage gently.
Despite its name, Epsom salt is not a salt, but a special compound of sulfate and magnesium that is mined in the city of Epsom, England. It is used for several medicinal purposes, including the treatment of bunions.
The properties of the substance guarantee the reduction of pain, swelling and inflammation of bunions. To bet on this treatment, you need to fill a basin with warm water and add two very generous spoons of Epsom salt. So, just submerge your feet for 20 minutes, once a day.
The rue is a plant widely used to reduce pain and inflammation that reach the joints, and for this reason, it is a very popular homemade treatment for bunions.
To enjoy the benefits of rue, just prepare an infusion of the plant with warm water, put the mixture in a basin and soak your feet for 15 minutes, once a day.
Larger bunches or those in a more advanced stage need surgical treatment to disappear completely.
The treatment is very diverse: there are more than 100 types of surgery to correct bunions today. Your doctor will choose the most suitable for you, according to the particularities of your case and health history.
The most common surgical choices for treating bunions are as follows:
The osteotomy performed to correct bunions is called distal metatarsal osteotomy, and can be performed in several different ways. The most common procedure is called Chevron Osteotomy.
In this type of surgery, the surgeon inserts a small screw into the metatarsus, with the intention of holding the bone in the correct position.
For this, a V-shaped cut is made in the part of the first metatarsus that is out of place, dividing the bone in two. Then, the two parts are aligned and fixed with the insertion of the screw.
Exostectomy basically consists of removing the bunion by scraping the bone at the injury site, without correcting the bone alignment.
Today, exostectomy is no longer used as an independent procedure, as removing the bunion without realigning the metatarsus causes the problem to eventually return.
So if your doctor opts for an exostectomy, know that this is probably just a complementary procedure. In general, exostectomy is performed in conjunction with osteotomy.
Also known as artificial ankylosis, arthrodesis is a procedure in which damaged joints located between two bones are immobilized. Its functions are now done with the help of titanium plates and screws.
Arthrodesis is considered a very effective procedure for the treatment of bunions, as it corrects deformity, provides stability for the feet and relieves pain.
The biggest disadvantage is that, after this type of surgery, the affected metatarsus is more susceptible to fractures, since it loses the impact absorption capacity that belonged to immobilized joints.
Bunion repair surgeries are considered simple procedures. Therefore, the operated person can be released as soon as they recover from anesthesia. In some cases, the medical team may request that the patient be under observation for a period of up to 24 hours.
From the day after the operation, the patient will need to wear orthopedic shoes called Baruk sandals every time he walks, in addition to making sure that the points of the surgery are not exposed to water or excessive humidity. This post-operative stage usually lasts about two weeks.
Then, the patient will need to spend a few more days with a special orthopedic boot. In some cases, the orthopedist may recommend the use of crutches to prevent the operated foot from being burdened with excessive weight during walking.
After about a month, the patient should be back to normal activities, including driving. The release for physical exercise will be in charge of the medical team.
A slight swelling at the surgery site can last for a few more months.
Physiotherapy is an important step in the postoperative process. The initial objective of the exercises is to contribute to the reduction of swelling and discomfort in the operated region.
Then, work on muscle and joint relaxation will begin, to ensure that the foot perfectly recovers all of its functions after surgical treatment.
Finally, the physiotherapist will invest in a process of muscle strengthening, so that the patient can return to walking and resume his normal routine smoothly.
Risks of surgery
90% of patients undergoing surgical bunion treatment do not suffer from any postoperative complications. The procedure offers a small risk of infections and injuries to nerves adjacent to the surgery site.
Although they are not serious, bunions are annoying: they are not pretty, they cause pain, they make simple activities difficult and they make putting on a shoe practically an impossible task. Therefore, it is important to consult a doctor as soon as possible to start the correct treatment and end the suffering right away.
Compresses and painkillers duly prescribed by a professional are usually the best way to live with the problem during treatment.
Another crucial point is to avoid physical activities that force the region and choose shoes that do not compress the bunion, avoiding pain, discomfort and even complications.
Care with the choice of footwear
Uncomfortable shoes are the biggest villains for those who live with bunions. Therefore, for your recovery, it is essential to dedicate special attention to the moment of choosing shoes for day-to-day life.
Some steps you can take:
- If you have bunions or a history of the disease, discontinue wearing high heels. Pointed toe shoes are also expressly prohibited;
- If you need to wear heels to work, prefer heels that are a maximum of 4 centimeters. Shoes that are taller than that put a lot of pressure on the toes, increasing discomfort and making the problem worse;
- Also pay attention to the stability offered by the jump. Prefer firm and wider heels, which will offer more support and support for your feet;
- Do not exercise with any shoes – especially if the activity involves running. Invest in a sneaker with shock absorbers, shock absorption and a firm sole;
- Do not wear tight shoes. A shoe that is the right size for you will have enough space for each of your toes, so that they are not under pressure. There will also be a small space left on the tip, which you can feel when squeezing that region of the shoe;
- Always wear your sneakers with the padded insole that comes inside them at the time of purchase;
- Wear boots made only of natural leather or suede, which will allow your feet to breathe and help keep the bunion from developing further. Synthetic materials are not recommended;
- If possible, prefer to use slippers, clogs and sandals, preferably with plenty of space for free movement of the fingers. This type of footwear is, in fact, the most suitable for those undergoing treatment for bunions.
Untreated bunions can lead to complications that – believe it or not – can be even more painful, uncomfortable and immobilizing.
The bursitis occurs when there is inflammation of the bursae, or synovial bags, which are small fluid – filled sacs that are in the space between a tendon or muscle and bone. It is popularly known as an inflamed bunion.
The deformity caused by the bunion can cause bursitis, which, in turn, causes severe pain and stiffness in the joints.
Also called a hammertoe (something like “hammer toes”, in free translation), the phenomenon of claw fingers is a deformity in which the tendons shrink and atrophy, leaving, as the name of the disease suggests, the toes curved into claw shapes. They may be an evolution of untreated bunions.
Metatarsalgia is inflammation of the metatarsals, caused by the stress of a bunion’s deformity in the region. In addition to causing even more pain, the disease also considerably limits the movement of the feet.
Bunion prevention is based on two pillars: comfort and healthy habits. To prevent the deformity from appearing on your feet, some measures that can be taken are:
Wear comfortable shoes
It is estimated that 90% of people affected by bunions are female, and not because of a physical or psychological issue, but rather a social one: women are more charged with wearing uncomfortable shoes – such as those with very high heels, for example – in professional and social situations.
Wearing comfortable shoes is the best way to prevent the growth and worsening of a bunion. Pay special attention to high-heeled shoes, pointed toes and to practice physical activities (for more information, read the subsection “Caring for the choice of footwear”).
Spend more time barefoot
Research shows that spending a few hours a day barefoot can have positive effects on the health of your feet. In the case of bunions, reserving a period of the day to run out of shoes can prevent or even cure the problem.
If possible, take a few minutes to walk on uneven terrain, such as sand or earthy places, for example. This practice will strengthen your fingers and joints, preventing the appearance of bunions.
Prepare a foot bath
Once a week, take a moment to fill a container with warm water and soak your feet for 20 minutes. It may be during the time that you usually use to watch television or browse the internet, for example.
The warm water has properties that help the joints and relieve pain and tension in the feet, thus preventing the appearance of bunions.
Stand upside down
If you work standing or sitting all day, it is very important to try to get home and spend 15 minutes with your legs up, lying on your bed or sofa.
The measure also aims to relieve tension in the feet, joints and tendons, in addition to improving blood circulation in the region.
Foods with vitamins A, C, D and Calcium can improve bone and joint health and thus prevent the appearance of bunions.
Include foods like:
Foods rich in vitamin A
- Liver steak;
- Boiled egg;
- Minas cheese;
- Sweet potato;
Foods rich in vitamin C
- Brussels sprouts;
Foods rich in vitamin D
- Chicken liver;
- Boiled egg;
- Cod liver oil.
- Skimmed and whole milk;
Doing some exercises that stimulate your foot joints is a great way to prevent bunions.
Make moves like:
- Use your hands to pull and stretch your big toe for a few seconds;
- Bend and stretch your toes repeatedly, slowly, at your own pace. Repeat the movements for 10 seconds;
- Press your fingers against a wall or on the floor, until you bend them back. This is a way to encourage flexibility in the region.
The bunion causes a lot of pain and discomfort, but, in general, does not represent any serious health problem. With proper treatment, the disease disappears completely and leaves no sequelae.
If you have any questions about bunions, leave it in the space below reserved for comments and we will answer soon. Also take the time to share your tips for dealing with the problem!