Bunions

Description & Prevention

Does your foot resemble a triangle, with the tip of your big toe angling inward and your joint jutting outward?  If so, you have a bunion.  And it probably hurts. 

The foot pain of bunions occurs when the knobby lump that forms at the outside of the big-toe joint becomes sore and swollen, irritating nearby nerves.  This is most likely to happen when your feet have been encased in shoes that press against the bunion. 

Go full on the toe box.  The toe box is the front of the shoe where the toes sit.  The toes of any shoes you wear should be round or square, not pointy.  Certain sport-shoe makers, such as New Balance and Avia, sell models with lots of toe room.  Among dress shoes, look for Easy Spirit and Nine West, recommends Nancy Elftman, a certified orthotist/pedorthist (a professional shoe fitter) in La Verne, California. 

Stick with flats.  Heels shift your weight forward to the ball of your foot, which is not a natural position, says Kathleen Stone, DPM, a podiatrist in private practice in Glendale, Arizona. 
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Treatment

Here's what to do for immediate relief and to prevent bunions and foot pain from getting worse. 

Try ice.  If your bunion feels hot and swollen, it may be inflamed.  Cool it down by applying a cloth-covered ice pack, suggests Marika Molnar, PT, director of West Side Dance Physical Therapy in New York City. " I like to use a Ziploc-type resealable plastic bag half-filled with water and crushed ice and wrapped in a damp cloth," she says.  Apply for 10 or 15 minutes, then remove for a few minutes to let your foot warm up before applying again.  If you have circulation problems in your feet or diabetes, you're better off avoiding ice for any foot problems. 

Exercise your toes.  Work the muscles that control the side-to-side movement of your big toe with the following exercise, says Molnar.  Sit with your feet flat and straight out in front of you.  Try to move your big toes toward each other, then bring them back.  If you can't manage this at first, use your hand to help move your toes. " The muscle that you are using is under the inside anklebone, about 1 inch down.  You can feel a little bulge at this spot as you contract the muscles.  This exercise helps properly align the joint by rebalancing muscles and stretching contracted tendons in your foot," Molnar says. " Unless your joint is very deteriorated, it will help keep your bunion from getting worse." 

Try to do five or six repetitions of the exercise every few hours. " This is a difficult exercise to do," she admits. " It takes time to begin to get it, and this muscle fatigues quickly."  Keep at it, and it will get easier. 

Measure your foot.  Experts advise selecting footwear that gives bunions plenty of space. " You must get the pressure off your bunions with properly fitted shoes," says Cheryl Weiner, DPM, a podiatrist in Columbus, Ohio, and president of the American Association for Women Podiatrists. 

To do that, always get your foot measured when you buy shoes, says Elftman.  Make sure that the width of your foot is measured at its widest point -- from your big toe across to your baby toe -- while you're standing barefoot or in socks. 

When to See a Doctor

If your bunions hurt every day, even with properly fitting shoes, or if the foot pain limits your activities, see a doctor.  Specially fitted orthotics (inserts worn inside your shoes) may help relieve bunion pain.  Or your podiatrist might recommend surgery to remove the bony overgrowth and help realign the bones in the big-toe joint.