A fairly common cause of pain at the base of the big toe is a bunion. In this case, we are talking about an issue in the joint (where the toe connects to the foot) that has allowed the toe to start angling inwards. As that happens, the joint itself becomes displaced and this creates discomfort, pain, and loss of mobility and function.
On account of bunion pain, you may develop an array of symptoms, but the biggest considerations are that you might lose your ability to do favorite activities or have pain when wearing certain shoes.
The good news is that our team here at Texas Foot and Ankle Center are highly trained and experienced in being able to treat this condition!
If you are suffering from bunion pain—or recognize the early stages of this problem—contact our Dallas podiatrist office and request the earliest possible appointment.
Why Do Bunions Happen?
Let’s start by clearing up a very common misconception:
Bunions aren’t actually caused by women’s footwear.
Many people think that’s the case, and for good reasons. After all, pumps, stilettos, and other high-heeled shoes not only place excess pressure on the front of the foot—the location of a bunion—but also typically have narrow, pointed fronts.
So it would make sense to think that these factors lead to the big toe pointing inward and the metatarsophalangeal (MTP) joint jutting outward.
(In just a second we’ll explain the MTP joint in a way that will probably be easier for you to understand.)
The fact of the matter is that bunions can be attributed to imbalance within the MTP joint, particularly in regards to the connective tissues holding everything together.
Okay, we’re going to hold up for a moment to get you up to speed with what “metatarsophalangeal” means (in case you don’t already know).
To put it into plain language, this is the joint where the big toe meets the foot. The medical term comes from the metatarsal bones—which are the long bones spanning your mid- and forefoot—and phalangeal bones found in your toes. Hopefully understanding this makes it easy to understand where that long names comes from.
Back to bunions:
As with virtually any other joint in your body, your big toe’s joint is supported by soft, connective tissues. When everything functions as intended, the tissues keep the bones in place.
That doesn’t happen with a bunion.
For various reasons—and especially simple genetic predisposition—the ligaments don’t do their job of keeping the big toe where it’s supposed to be.
What kinds of factors contribute to bunions?
Now, just because high-heeled footwear isn’t the root cause for bunions doesn’t mean those stylish shoes are off the hook:
Whereas they might not cause a bunion, pumps and stilettos (etc.) can contribute to them.
So if you have existing issues in the big toe’s MTP joint, high heels can definitely make the problem worse.
Along with footwear choices, another major factor for many bunions is overpronation.
For the uninitiated, pronation is a completely normal biomechanical process your feet undergo during the ground portion of every step—one that entails an inward rotation of about 15 percent (give or take).
When the amount of inward rotation is greater than that, we call it overpronation. This tends to be commonly seen in individuals who have low foot arches (flat feet).
As the foot rotates farther than it’s intended, greater amounts of physical stress and pressure are placed on the inner, front part of the foot—right where the big toe’s MTP joint is located.
One final factor worth noting relates to the fact that women are—by far—more likely than men to develop bunions. The reason for the discrepancy may be attributed to a specific hormone called relaxin.
Relaxin has an important role in allowing females to give birth, which is something most men are incapable of doing at the present time. What it does is to relax ligaments, and particularly the ones found in the pelvic region. In spite of that, this hormone does affect connective tissues found elsewhere in the body—including down in feet.
How can you recognize a bunion?
As a starting point, you will likely be able to visually recognize this condition by the fact the big toe is pointing inwards (instead of straight ahead) and there’s a noticeable bump on the inside edge of the foot, right at the MTP joint.
Beyond visual cues, you may experience difficulty wearing certain kinds of shoes (like the aforementioned high-heeled models).
Another form of difficulty is the actual functionality of the joint itself. With the joint being forced out of position, you will start to lose the toe’s natural range of motion. And this can create a rather painful situation.
Pain and loss of joint mobility are major symptoms. Others include:
- Calluses and corns
What kinds of bunion treatment options are available?
Along with “bunions are caused by women’s shoes,” a second misconception that people often hear is “they can only be treated with surgery.”
We’ll discuss bunion surgeries in a second, but that isn’t an entirely accurate statement.
The fact of the matter is this:
Whereas the only way to truly correct a bunion is through surgical intervention, conservative care might be used in cases that are either mild or caught early.
For those situations, the goal of treatment is to A) relieve symptoms and B) halt further progression.
Nonsurgical options include:
- Footwear choices. In very early stages, switching from shoes featuring narrow fronts and/or high heels to low-heeled models with deep, wide toe boxes can avoid too much friction or pressure being placed on the affected area.
- Custom orthotics. Changing to different shoes can potentially be a step in the right direction. For cases that are further along in development, we may recommend custom-fitted orthotic devices. The intent with this option is to correct biomechanical issues (like overpronation) to redistribute pressure from the forefoot area.
- Icing. One of the ways to reduce inflammation and pain from an early or mild bunion is to ice it for around fifteen minutes at time. Of course, when doing this, the ice should be wrapped in a thin towel to prevent damage to your skin.
- Medication. If you are using over-the-counter medications—such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium—make sure you consult with our office for specific recommendations regarding types and dosage. If necessary, we may recommend using prescription medication, but this is something we will need to discuss together.
As noted, the only way to actually correct a bunion and restore the toe and joint to their natural positions is with surgery.
When it comes to bunion surgeries, there are a variety of techniques and surgeries we can use. The specific nature of your procedure(s) will depend on your unique case. (All feet and situations are different.)
No matter which procedure(s) are recommended for you, it’s important to know that bunion surgeries are usually successful and a vast majority of our patients report improvement and favorable outcomes.
The professional bunion care you need—right here in Dallas!
At the end of the day, here’s something you should know about your bunion:
This is a progressive condition. What that means is it will continue to worsen over time if left unaddressed.
Instead of letting a bunion get to the point where it’s causing pain, difficulty, and can only be fixed with surgery, see us as soon as you become aware of the problem. We may be able to avoid surgery and use conservative methods to relieve symptoms and halt progression.
If you have any questions—or are ready to request your appointment for professional bunion treatment in Dallas—give us a call or connect with us online. You can reach us at (214) 660-0777 or use the contact form here on our website.
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Dallas, TX 75218
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