Dr. Andrew Marso, DPM
Milwaukee Bunion Specialist
Podiatrist Specializing in Relief of Bunion Pain
Dr. Andrew Marso is dedicated to providing a wide range of effective bunion treatment options to help you get back on your feet and live without pain. Born and raised in nearby Franklin, Dr. Marso takes pride in giving back and improving the lives of those in his community.
Bunions (Hallux Valgus)
A bunion is a painful bony bump that forms on the outside of the big toe. This foot deformity occurs from years of pressure on the big toe joint. Eventually, the toe joint gets out of alignment, the soft tissues become inflamed and a bony bump forms. The medical term for bunions is hallux valgus.
What is a bunion?
A bunion (hallux valgus) is a bone deformity that results when the big toe moves out of place, causing enlargement of the metatarsophalangeal joint at its base. The enlarged joint pushes the toe down against the shoe wall, building considerable friction and pressure.
What are the types of bunions?
Bunions on the big toe are the most common. Other types include:
- Congenital hallux valgus: Some babies are born with bunions.
- Juvenile or adolescent hallux valgus: Children and teens between the ages of 10 and 15 may develop bunions.
- Tailor’s bunion: a bunion that forms on the outside base of the little (pinky) toe and is also called a bunionette
Signs/Causes of Bunions
What are common signs of bunions?
A bunion looks like a swollen, red vegetable. In fact, the French word for bunion ‘oignons’ also means onion. Other symptoms include:
- Not able to bend the big toe, or pain and burning when moving it
- Rubbing against shoes
- Calluses (patches of thick, dry skin)
- Hammertoes (painful, malaligned toes)
- Numb big toe
What causes bunions?
The big toe bends in toward the second toe as a result of pressure from the way you walk (foot mechanics) or the form of your foot (foot structure). Bunion pain develops gradually over time. Wearing poorly fitting, narrow shoes for lengthy periods of time can make bunion discomfort worse, but they do not cause it.
Bunions are more common among women and in families with a history of bunions on either side of the family. They also often appear after pregnancy when hormonal changes cause the ligaments to loosen up.
What are the risk factors for bunions?
If you have any of the following traits, you’re more likely to get a bunion:
- Family history of bunions due to inherited foot structure problems
- Osteoarthritis This condition may cause changes to your foot structure, which can lead to a bunion.
- A leg-length inequality (meaning there’s a difference in the length of your legs) and/or an uneven gait (when you walk).
- Pregnancy. During pregnancy, your body produces a hormone that loosens joints. This can lead to increased laxity around your big toe joint and may cause or worsen a bunion.
- Systemic lupus erythematosus (lupus), rheumatoid arthritis, psoriatic arthritis, or any other autoimmune disorders. These conditions can attack the joints in your body, including those in your toes and feet.
- Overweight . Extra pressure on the joints of your foot may cause a bunion to form.
- Previous injury that causes an altered walking pattern (for instance, favoring one leg) can increase stress on your feet, which may lead to the development of a bunion.
Diagnosis & Tests for Bunions
How are bunions diagnosed?
A bunion is generally identified through visible inspection by a podiatrist, as many of the symptoms are readily apparent. When your podiatrist examines you, he or she may move your toe from side to side or up and down to check for restricted mobility. To further evaluate the joint or bunion deformity, he or she will order an X-ray.
The podiatrist may also take a look at and identify any existing and chronic conditions you have. Some patients who suffer from arthritis or other bone disorders may have visible bone spurs or joint damage that can result in bunions.
How are bunions treated?
Bunions do not improve spontaneously and may worsen over time if untreated. There are two main forms of treatment: Conservative & Surgical.
Conservative treatment options vary depending on the severity of your bunion and how much pain it causes. Nonsurgical treatments that may relieve the pain and pressure of a bunion include:
- Orthotics — custom-made insoles that fit into your shoes and try to help improve the functioning of the foot and bit toe joint
- Changing shoes – Wear roomy, comfortable shoes that provide plenty of space for your toes.
- Padding – Over-the-counter, nonmedicated bunion pads or cushions may be helpful. They can act as a buffer between your foot and your shoe and ease your pain.
- Medications – Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help you control the pain.
- Wearing a splint – Your doctor may prescribe an orthotic that you wear at night to keep your big toe from pointing down and relieve some of the pressure on the joint.
Surgical treatment may be needed to reconstruct and restore alignment and function to the toe may be necessary.
Before treating your bunion, you should have an examination from a podiatric physician to gain a better understanding of the condition.
How to prevent a bunion from getting worse
Choose shoes with care to avoid bunions. They should have a broad toe box — no sharp toes — and there should be space between the end of your longest toe and the shoe’s tip.
Your shoes should form to the shape of your feet without compressing or rubbing against any part of your foot.
If you have flatfeet or another inherited structural foot problem, custom-fitted orthotics can help prevent, or slow the progression of bunions.
What are the complications of bunions?
Associated complications of bunions include:
- Bursitis – inflammation of the tiny fluid-filled pads near your joints that become inflamed, causing this painful condition.
- Hammertoe – An abnormal bending up of the lesser toes, usually the toe next to your big toe, can cause pain and pressure in shoes.
- Metatarsalgia – condition causes pain and swelling in the ball of your foot
What is the prognosis of people with bunions?
Bunions can get more painful over time without the appropriate treatment, such as switching your shoes or using orthotics. This is because the big toe starts to deviate more toward the other toes, which can put more pressure on your bunion. It may also lead to bursitis, where fluid accumulates in a small cavity near your joint. This can cause irritation and swelling that makes it hurt to walk even more.
Bunions should never be ignored because it can become harder to find shoes that fit properly. Having a bunion might also lead to arthritis in the big toe joint, so get help if you have any of these signs or symptoms.
Prognosis is best when corrected early. With treatment, most people experience an improvement in their symptoms within six months.
Long-term outcomes are usually better if your bunion has not caused any changes to the 2nd toe, as this makes it more difficult to correct. Hammertoes are common if you have had a long-standing bunion that has not been treated appropriately.
Seeking Care for Bunions
When should I call a podiatrist about my bunion?
You should call your podiatrist if you:
- Painful with walking or rubbing in shoes
- Limited motion in the big toe
- Redness or severe inflammation of the toe
- Big toe is starting to drift towards the 2nd toe
What questions should I ask my podiatrist about bunions?
You may want to ask your podiatrist:
- What caused my bunion?
- How severe is my bunion?
- What are the best treatment options for my bunion?
- What can I prevent getting a bunion on my other foot?
- What risks am I taking if I don’t treat my bunion?