8 Effective Solutions For Bunion Pain
The underlying cause of bunions is genetic: Most people with bunions have inherited flat feet or feet that overpronate (roll inward more than normal), issues that leave feet more vulnerable to the development of bunions. But shoes with narrow, pointy toes can also trigger them, and high heels—which force toes into the front of shoes—exacerbate the problem. So it's no surprise that 90% of bunions occur in women.
MORE: 10 Things Podiatrists Wish Everyone Knew About Their Feet
In most cases, bunion pain can be managed by switching to shoes that are roomy enough to accommodate the bunion and allow you to wiggle your toes. A square toe box is the most desirable shape, but a round one is still better than a pointed one. Low heels (no more than an inch high) are ideal, but if style wins out, at least look for shoes with a stable heel that's relatively wide. And opt for soft leather over synthetic materials, which cause the foot to sweat, leading to blisters. "I've seen patients who've completely worn out the skin overlying their bunion by wearing footwear made of synthetic materials," reports Joan Oloff, MD, a foot and ankle surgeon in Los Gatos, CA, who created a line of high-fashion, foot-friendly shoes. Another no-no: shoes that have seams in the toe box, which can rub up against and irritate bunions.
Topical or oral nonsteroidal anti-inflammatory drugs (NSAIDs) like acetaminophen, ibuprofen, or naproxen can help control the pain of a bunion. (Just avoid these pain med mistakes.) For severe bunions, an injection of cortisone right into the joint can reduce swelling and discomfort. Because the injection is so localized, it often does a better job than taking a pill. But because the inflammation will build up again, the results are likely to be temporary.
These molded shoe inserts work to correct the mechanics that cause a bunion to form. "Orthotics limit abnormal pronation, which in turn stabilizes the big toe joint and the bones in the foot," Oloff explains. So besides minimizing pain, orthotics may also keep bunions from progressing. For serious cases, pricey custom-made inserts, which are specifically shaped to your feet, are often necessary. But people with less severe problems should try OTC insoles first—Oloff says she often uses them when patients need immediate help. "Even if we proceed with custom orthotics down the road, the initial relief makes them worth a try."
There's a dizzying array of these types of products—some are flexible and can be worn inside your shoe, while others are rigid and can only be worn at night. Many (falsely) claim to be able to correct your bunions. "There's no way these products can overcome the forces that created the bunion," says retired podiatrist Mayde Lebensfeld, DPM. However, because they move the toe into proper position and relieve tension on the tendon and toe muscles, these gadgets may temporarily alleviate bunion pain.
Since the mechanics of everyone's feet are different, you'll need to do some experimenting to find a splint or brace that works for you. Just be sure to manage your expectations, advises Oloff. "Some people will feel that they help a little, some will feel they help a lot, and others won't feel they help at all."
Surgery is generally a last resort, but it's the only method that's been proven to truly correct a bunion and eliminate the pain it causes.
There are several types of surgery, and the options vary depending on whether your deformity is mild, moderate, or severe. While many people are glad they went through with the procedure, there's no guarantee: One study found that about a third of patients were dissatisfied, even when their pain and toe alignment improved; in another survey, 85 to 90% of patients were happy with the results. The good news, says Oloff, is that there's rarely any need to rush into bunion surgery, so you can (and should) try other fixes first.
Video: Yoga for Bunions, Toe, Ankle & Foot Tension
David Livingstone Smith, PhD
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