A bunion is a misaligned joint at the base of the big toe.
Your big toe has two joints. The larger one is the metatarsophalangeal (MTP) joint. It gets its name from its location: where the first metatarsal (long foot bone) meets the phalanx (first toe bone).
The MTP joint is essential for walking. When you take a step, the joint bends so you can push off the foot and move the other leg forward. For a brief moment, the MTP joint has to fully support half your body weight.
The joint is strong, but it does have its limits. The constant pressure pushes the joint out of alignment.
At Chicagoland Foot and Ankle, board-certified podiatrist Dr. Robert Sheffey and our team see many patients of all ages who have developed bunion problems.
The MTP joint may be painful, swollen, and red, or you may have no symptoms at all. As custom orthotics are one of the common, conservative treatment options, many of our patients wonder if they can correct the bunion problem. Here’s what our experts have to say.
Developing bunions step-by-step
Bunions form over the course of many years, which is why they’re more prevalent in the older population.
For people who don’t have a genetic predisposition, the process usually begins with repeated compression of the toes, such as wearing shoes with a narrow toe box or high heels, the latter of which shifts your body weight to the front part of the foot, straining it.
The constant pressure on the toes weakens the ligaments that keep the big toe in a straight position. As a result, the top joint of the big toe shifts toward the other toes, while the MTP joint moves outward, creating the characteristic bony bump on the inner part of your foot.
More causes of bunion development
There’s no argument that stressing the MTP joint plays a role in bunion formation, but it's not the only player. Researchers suspect bunions form due to a combination of factors:
- Foot injuries
- Arthritis (joint inflammation)
- Abnormal bone structure
- Flat feet
- Extremely flexible ligaments
And while there’s also no argument that a narrow toe box and high-heeled shoes are contributing factors, researchers aren’t certain if they cause bunions to develop or if they simply worsen a preexisting condition.
Bunions change your foot structure, which means you may experience complications other than just pain and irritation.
Bursae are fluid-filled sacs that cushion the joint space and permit smooth movement of structures when you bear weight. If the MTP joint shifts out of position, it can irritate the bursa, leading to inflammation, swelling, and limited movement. This condition is called bursitis.
Hammertoes are another common complication.
When the top of the big toe shifts toward the second toe, it can slide underneath it and push its middle joint upward. That gives the toe a hammer-like appearance.
Unfortunately, it not only gives the toe a more limited range of motion, but the bent joint can rub against the tops of your shoes. That may lead to calluses, pain, and open sores.
A third complication is metatarsalgia. Because the MTP joint is deformed, it forces you to alter your gait to relieve the discomfort. You end up putting more pressure on the ball of your foot, causing it to swell and become painful.
Can orthotics correct bunions?
Custom orthotics are medical devices that slip into your shoes and provide cushioning and support for your arch, heel, and ball, allowing you to walk more normally.
They can improve small bunions that don’t cause much pain. You can ease any pain you do have with over-the-counter anti-inflammatories like ibuprofen and naproxen.
Unfortunately, when the MTP joint becomes deformed, it doesn’t have the ability to repair itself, even with rest and time. But at Chicagoland Foot & Ankle, we offer noninvasive therapies that can help with the symptoms.
If your bunions are moderate in size, and if they lead to any complications, physical therapy is a good treatment option. The exercises strengthen the joints and tendons in your foot while preventing further complications.
If you’re in too much pain to engage in physical therapy, we may give you a steroid injection directly in the MTP joint.
A fast-acting anesthetic provides immediate relief, while the steroid works over a longer period to calm the inflammation. That should give you a relatively pain-free period of a couple of months to do the exercises.
Are you struggling with the pain and discomfort of bunions? Chicagoland Foot and Ankle can help. Call any of our locations, or book your appointment online today. We have offices in the Mount Greenwood and Portage Park areas of Chicago, and in Orland Park and New Lenox, Illinois.