Bunion Q & A

Bunions are a common foot problem that develops over time, usually caused by a combination of genetic factors and shoe-wear habits. While bunions can be painful, they do not always require intervention by an orthopedic doctor, like Dr. Kleis. However, if the condition is consistently painful, worsening, and causing difficulty finding shoes that fit comfortably, you may need an examination and treatment for your bunions.

Dr. Kleis is an orthopedic doctor providing treatment for bunions in Costa Mesa and all of Southern California. Dr. Kleis has more than 25 years of experience treating all manner of foot disorders, including bunions, and can recommend a personalized treatment plan for you. To schedule an appointment for bunions, please call (714) 760-4944.

What is a Bunion?

A bunion is a painful bump that develops at the base of your big toe joint. The visible part of the bunion is caused by a bony bump that develops in the joint of the big toe. Bunions form because of a misalignment of the bones of the big toe. This misalignment can occur because of genetic predisposition or because of the shoes that are being worn.

Men and women who have a genetic predisposition to bunions may develop bunions as they age, regardless of the type of shoes that they wear. However, the most common cause of bunions is wearing shoes that are too tight or that force the toes into narrow casings. High-heels are a common cause of bunions, as the lift of the heel and the narrowness of the toe box combine to push the bones of the big toe out of alignment and rub the joint of the big toe along the shoe. Over time, a bony protrusion develops in the joint. This bony protrusion becomes a bunion. This process happens gradually, changing the angle of your toe bones over the course of years and developing the bony bump over time.

In addition to the development of a tender bump along the inside of your foot, a bunion may cause your big toe to overlap with your second toe. Calluses and corns from this overlapping may form where the two toes rub together, causing secondary aggravation that requires treatment.

Tailor’s Bunions

Bunions that form on the little toe and create a bump along the outside of your foot are called bunionettes or Tailor’s bunions. A tailor’s bunion forms alongside the bottom joint of the fifth, or little, toe. These bunionettes can be particularly painful when they rub against the outside of the shoe. While regular bunions are fairly common, tailor’s bunions are not nearly so frequently occurring. Only 4% of the population report tailor’s bunions, while 39% of the general population suffers from regular bunions.

What Causes Bunions?

Bunions are caused by a combination of genetic and environmental factors. Men and women with a family history of bunions are at higher risk to develop bunions. However, people with no family history of bunions can develop them from the types of shoes that they wear.

Women experience bunions at a higher rate than men, mostly because of the style of shoes they choose. High-heels are especially bad for causing bunions when worn frequently and over long periods of time. Other shoes that have narrow toe boxes that force the toes forward and out of their natural alignment are also culprits for causing bunions to form.

Bunions can be prevented or mitigated by choosing footwear that fits properly and allows your foot to remain in a natural position. If you know your family is susceptible to bunion development, your choice of footwear is especially important.

Shoes That Help Prevent Bunions

Shoe choice is extremely important when treating or preventing bunions. Be sure to choose shoes that have a wide toe box and allow your feet to maintain their most natural position. Don’t wear high heels or other shoes that force your foot forward into the shoe, moving your toes out of alignment. Ensure that your shoes leave plenty of room between the tip of your longest toe and the end of the shoe so that your feet can remain in their natural position. Shoes that are too small will force your toes out of alignment and make you more susceptible to bunion development.

Bunions – An Occupational Hazard?

Certain occupations can contribute to bunion development, as well. Teaching, food prep, forestry, retail workers, and janitorial staff are just a few of the occupations that are guaranteed to keep you on your feet all day. For people who work in these fields, choosing the appropriate footwear is extremely important. Shoes with proper arch support and a wide toe box are key to happier feet and preventing bunions.

Genetic Risk Factors For Bunions

Bunions can be caused by a genetic abnormality in the foot structure that causes the big toe to lean inward. Women and men with a family history of bunions are at higher risk of developing a bunion.

Wearing shoes that are too tight, narrow, or don’t fit properly, especially when combined with a genetic predisposition, can also increase your susceptibility to bunions. Although bunions can affect anyone, this condition is much more common in women.

Occupations or activities that require spending lots of time on your feet, such as teaching, may also aggravate bunion symptoms.

Symptoms of Bunions

Bunions may cause a variety of symptoms and foot problems. Common bunion symptoms include:

  • Redness and swelling
  • A firm, painful bump at the base of the toe
  • Corns or calluses
  • Hammertoes
  • Ongoing pain
  • Movement in the big toe becomes limited

Over time, bunions can become so painful that it’s difficult to wear shoes or walk normally. Many women and men suffer from the pain of bunions for years before seeking treatment, but Dr. Kleis can help you today.

Choosing the Correct Shoes for Bunions

Choosing the correct footwear is an important step in both preventing and treating bunions. Bunions are caused by shoes with narrow toes, especially those with high heels, that force the toes to move together to fit into the narrow toe box. Once a bunion has developed, continuing to wear narrow shoes will irritate the bunion further and cause it to increase in size and painfulness.

If the bunion is still small in size, a comfortable shoe with plenty of room in the toe might be all that is called for. Adding a half-size will ensure that your toes have plenty of room to move around in and help avoid hammertoe, a complication often associated with bunions.

An alternative to purchasing new shoes is to use a shoe stretcher to stretch out the toe box of your shoes to create more space. If you don’t have or can’t find a shoe stretcher, your local shoe store may have one they can use to stretch your shoes for you.

A podiatrist can help you find shoes that best support and fit your foot. Podiatrists have access to orthotic shoes, specially-made shoes that accommodate a wide range of foot abnormalities.

Complications From Bunions

Over time, if bunions are left untreated, they may develop complications. Some complications of bunions include bursitis, hammertoe, and metatarsalgia.

Bursitis – Bursitis is a painful condition where the bursae become inflamed and painful. Bursae are the pads that cushion the bones around your joints. When the bursae are irritated and inflamed, bursitis in the diagnosis and the condition is quite painful. Bursitis occurs most commonly in the shoulder, elbow, and hip, but can occur in any joints that are chronically inflamed.

Hammertoe – Hammertoe is a deformity of the second through fifth toes, caused by abnormal pressure being put on the toes. In the case of bunions, the big toe bends over into space normally occupied by the smaller toes, forcing those toes into abnormal positions, as well. As the condition worsens over time, the toes begin to look like a “hammer” or upside-down V. When treated early, hammertoes can be remedied without surgery. But, if the condition is allowed to progress, the toes will lose their flexibility and may require surgery.

Matatarsalgia - Metatarsalgia is a condition that is manifest with a sharp, burning pain in the ball of your foot or a feeling that you have a pebble in your shoe that you can’t get rid of. When a person has bunions, the big toe often pushes the other toes out of their regular alignment, causing the nerves in the ball of the foot to become inflamed and irritated.

Diagnosing Bunions

Dr. Kleis begins with a thorough physical exam and review of your medical history. Although the bunion may be visibly obvious, he may take an X-ray to evaluate the extent of your condition or to rule out any other causes for pain.

Treating Bunions

Once bunions have been diagnosed, Dr. Kleis will develop an individualized treatment plan for you. Depending on the severity of your condition, your bunion treatment plan may include:

  • Low-level laser treatment or acoustic wave therapy
  • Padding the bunion
  • Oral or injectable anti-inflammatory medication
  • Orthotic devices

Dr. Kleis examines every possible treatment before recommending surgery. However, if your bunion causes severe pain or doesn’t improve with nonsurgical treatment, he may advise surgery to remove the bunion and correct your foot alignment.

If you have a bunion, don’t hesitate to call or book an appointment online for expert treatment with Dr. Kleis.

 

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