What is a bunion?

St. Joseph’s/Candler Physician Network Podiatrist Dr. Prianka Sharma explains treatment options for this foot deformity

Have you ever looked at your feet and noticed a bony bump on the inside of your foot at the big toe? You wouldn’t be alone. That deformity is called a bunion and nearly 3 million Americans have one.

A bunion is a painful bump that is actually the anatomic bone that is misaligned, explains Dr. Prianka Sharma, podiatrist with St. Joseph’s/Candler Physician Network – Podiatry. A bony bump on the opposite side of the foot is called a tailor’s bunion or bunionette.

The foot is one of the most complex parts of the body. It is made up of 28 bones connected by many joints, muscles, tendons and ligaments. The big toe is made up of two joints and two bones. The larger of the two joints is the metatarsophalangeal joint (MTP), which is where the first long bone of the foot (the metatarsal) meets the first bone of the toe (the phalanx).

Bunions develop at the MTP joint when the metatarsal begins to shift towards the inside of the foot and the phalanx angles towards the second toe. The MTP joint gets larger and protrudes from the inside of the forefoot.

There are a variety of reasons bunions occur. Most commonly, it’s hereditary, Dr. Sharma says. Women are more prone to bunions than men often due to wearing tight, pointed and confining shoes.

Bunions develop slowly over time but as they become larger they also become more painful.

“Most people complain of friction against the bump, especially in regular shoes, as well as stiffness in the joint because if your bone is out of alignment it does affect your bone joint, which can be very painful and stiff,” Dr. Sharma says.

Severe bunions also can cause pain while walking because the big toe plays such an important role in gait.

“Your big toe joint is really responsible for toe off when you are walking, so when you take a step and your heel comes off the ground, your big toe joint is hyper flexed at that time,” Dr. Sharma says. “The big toe joint goes through a lot of motion when you are walking.”

How to treat a bunion

There are a lot of misconceptions about bunion treatment, Dr Sharma says. Most commonly, patients think a bunion can be shaved off. Unfortunately, there’s no real conservative treatment to treat a bunion. There are accommodating methods, such as wearing a wider toe shoe, box shoe or pads that help with rubbing.

Ultimately, as the bunion gets worse with time, corrective surgery is the best method of treatment; however, Dr. Sharma only recommends surgery when it’s absolutely necessary. “I don’t think all bunions need to be treated surgically. I think if it’s painful, you should treat it. If it’s not, leave it alone and wear wide shoes.”

When it is time for surgery, there are options depending on the severity of the bunion. Dr. Sharma begins by taking X-rays and making measurements of the deformity to determine the best procedure.  Most bunion corrections are outpatient procedures.

The less severe the bunion, the sooner you will be back on your feet following surgery. A special shoe may be required, but weight bearing on the big toe should not cause any pain. In more severe cases, the procedure may be more involved, Dr. Sharma says, which does require time putting no weight on the foot.

One specific surgery Dr. Sharma offers is called a percutaneous bunion procedure. It only requires a centimeter incision to correct the deformity with a pin. The pin will need to stay in the foot for four to six weeks, but you can walk immediately following surgery and are not left with a huge scar.

Bunions are very common and unfortunately cannot be prevented. If you or someone you know has a painful bunion, talk to your physician about getting a referral to a podiatrist. Whether it’s wider shoes or surgery, they can help you alleviate foot pain.

To learn more about Dr. Sharma and St. Joseph’s/Candler Physician Network – Podiatry, visit our website.