Non-surgical Treatment Options for Bunions

What Are Bunions?

Bunions are painful bony projections at the base of the big toe joint that develop when the big toes lean towards the remaining toes. Medically, the condition is referred to as hallux valgus. It is more prevalent in females and is among the most common foot deformities. Pain can occur in the bony projection due to shoe irritation and the alteration of mechanical forces on the ball of the feet. Individuals born with an abnormal bone alignment in their foot have a higher chance of developing a bunion. The condition can run in families. The symptoms are mostly seen at later stages, while the condition may be asymptomatic in some.

What Are the Causes?

• Most occur due to an inherited abnormal mechanical foot structure.

• Using high-heeled, narrow-toed shoes places the toes in an unnatural position, increasing the chance of developing bunions.

• Neuromuscular conditions like polio or Charcot-Marie-Tooth-Disease and inflammatory conditions like rheumatoid arthritis increase the chance of developing bunions.

What Are the Symptoms?

• Bony projection on the first toe joint.

• The big toe turned inward towards the other toes.

• Tenderness and pain.

• Inflammation and redness (the skin appears darker than the surrounding skin).

• Difficult to use regular footwear.

• Pain gets worse while walking or while using shoes.

How Is It Diagnosed?

• Mostly, the diagnosis can be made by the physician by clearly examining the foot and based on symptoms.

• The physician takes a detailed patient and medical history.

• X-rays check the toe alignment and disease severity and assess other conditions like arthritis.

Can Bunions Be Corrected Without Surgery?

Bunions are a progressive condition that worsens over time. Treatment options depend on several factors, like the severity of symptoms, the type of deformity, and other medical conditions like diabetes, rheumatoid arthritis, etc.

Conservative or non-surgical treatment options mainly focus on relieving symptoms and slowing disease progression. But these cannot correct the bone misalignment, for which surgical treatment is needed.

The non-surgical treatment options include:

1. Footwear Change:

Bunion pain can mostly be managed by using properly fitting shoes. Shoes with a wide-toe box should be used. Certain shoes are used with a stretcher that stretches out the areas that put pressure on the toes.

2. Orthotics:

Orthotics aid in slowing the progression of the condition. Over-the-counter orthotics or prescription shoe inserts can be used. Orthotics help with even weight distribution across the feet and reduce pressure on the big toe.

3. Splints and Spacers:

Toe spacers can be used to keep the toes in a normal position. Splints are used at night to keep the toes straight, preventing the joint from stiffening. The main goal of using splints and spacers is to slow down the disease and reduce the symptoms.

4. Medications:

Pain and swelling at the region of the base of the big toe joint are common bunion symptoms. Analgesics like NSAIDs (non-steroidal anti-inflammatory drugs) can be used as ointments or tablets to reduce pain and swelling. Tablets should be avoided for a longer period of time due to the potential side effects associated with them.

5. Exercises:

Physiotherapy can be done to stretch and strengthen the foot muscles.

Exercise may also aid in increasing flexibility and reducing pain. However, exercises alone do not correct bone misalignment.

6. Paddling:

Protective silicone pads can be used inside the shoes; this cushions the painful region over the bunion. These can be purchased from a pharmacy or drug store.

7. Hot and Cold Therapy:

Cold therapy constricts the blood vessels and helps reduce swelling. So bunions are soaked in cold water to reduce inflammation.

Heat therapy improves blood flow and helps relax sore joints and muscles.

Ice packs and heating pads can also be used. Icepacks can be wrapped in a tea towel and applied to the bunion region for about 5 minutes.

A combination of heat and cold therapy may relieve the symptoms.

8. Healthy Weight Maintenance:

Maintenance of a healthy weight prevents excess pressure on the foot.

9. Natural Remedies:

Some natural remedies one can follow for bunion relief are:

• Keep the feet elevated when in a sitting or lying position.

• Foot exercises.

• Foot massage.

• Take off the shoes and stretch the toes whenever possible.

What Are the Tips One Can Follow While Selecting Proper Footwear?

The following are the tips one with a bunion can follow while selecting footwear:

• Avoid sharply pointed, tight, high-heeled, or sharp shoes. Using high-heeled shoes increases pressure on the forefoot region, increasing the risk of developing foot issues.

• Choose stable shoes with broad-toe boxes and soft soles.

• Avoid selecting shoes based on shoe size, as sizes vary per brand. So select a shoe based on one’s fit.

• Select shoes based on one’s foot shape.

• Measure both feet before selecting a shoe, as in most cases; one foot is larger than the other.

• Avoid buying tight-fitting shoes with the expectation that they will stretch with time.

• The heel should fit comfortably in the shoes with minimal slippage.

• Use loose, thin socks to prevent pressure on the bunion.

When Should Bunion Surgery Be Considered?

If the symptoms are severe and cannot be managed by non-surgical treatment options, bunion surgeries are considered. Therefore, surgery is not necessary in all cases. Non-surgical management options cannot correct bone misalignment, so they are not a permanent cure.

But when non-surgical options fail to reduce pain and other symptoms, if the condition progresses despite using conservative options, or if the symptoms severely affect the patient’s activities, then surgery is considered.

Can Bunions Recur?

There are still chances for a bunion to recur after surgery. To prevent recurrence after surgery, the physician may recommend splints or orthotics to reduce pressure on the foot. The surgeon will suggest the types of exercises to be performed.

Conclusion

Bunions are bony projections at the base of the first toe joint region. These are progressive conditions; the symptoms can be reduced, and progression slowed down by various non-surgical options like orthotics, splints, appropriate footwear, medications, etc. However, surgery is considered a permanent cure for severe symptoms or the failure of non-surgical options.