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Is Your Big Toe Drifting?

Have you noticed your big toe moving over toward your second toe?  Or that you have a bump at the base of your big toe? If so, then you likely have a bunion.  A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. Bunions form when your big toe pushes up against your other toes, forcing your big toe joint in the opposite direction.  Over time, the bunion can become larger, further crowding your other toes and causing pain. 

Bunions can be inherited (Thanks Mom!), they can be caused by wearing ill-fitting shoes such as high heels, or they result from having an inflammatory condition such as Rheumatoid Arthritis.  Bunions can also be present in the adolescent population, most commonly in girls.

Signs and symptoms of a bunion include:

  • A bump on the outside of the base of your big toe
  • Swelling, redness or soreness around your big toe joint
  • Thickening of the skin on the side of your big toe
  • Achy and/or burning pain that can be persistent or intermittent
  • Stiffness in the big toe joint

Treatment options vary depending on the severity of your bunion and the amount of pain it causes you.

Nonsurgical treatments that may relieve the pain and pressure of a bunion include:

  • Changing shoes: Wear roomy, comfortable shoes that provide plenty of space for your toes.  
  • Padding:  We can make padding recommendations that will reduce stress on the bunion and alleviate your pain.
  • Medications: Oral medications may help control the pain of a bunion. Cortisone injections may be helpful as well.
  • Shoe inserts: Inserts can help distribute pressure evenly when you move your feet, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter arch supports can provide relief for some people, though others may require prescription orthotics.

Surgical treatments are reserved for those patients who do not get relief from conservative care.  There are a number of surgical procedures to correct bunions.  The severity of the bunion determines which procedure is most appropriate.  The goals of surgery are to relieve pain and reduce the deformity by realigning the first metatarsal bone and straightening out the abnormal angle in the big toe joint. Surgery isn’t recommended unless a bunion causes you frequent pain or interferes with your daily activities. Bunion surgery, like other types of surgery, is not without risk.  Always try conservative treatment before considering surgery.