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How Do You Treat Bunions?

Wondering what to do about a painful bunion? In this article, Dr. Sachs discusses some conservative and surgical treatment options.
August 31, 2020 | 3 min read
Brett Sachs, M.D.
Orthopedic Surgeon

A bunion, also referred to as hallux valgus, can be painful. When it comes to relieving bunion pain, there are many different treatment options. Depending on the severity of your bunion pain, these can range from conservative, non-invasive treatments to bunion removal. Be sure to consult your doctor to discuss the best treatment plan for you.

Conservative (nonsurgical) treatments

1. Wide, supportive shoes. Wearing more comfortable shoes that accommodate the bunion deformity and provide more space for the toes may help avoid friction against the bunion.

2. Orthotics and over-the-counter inserts. Shoe inserts and prescription orthotics help provide additional support for the foot and can redistribute pressure across the foot. Inserts and orthotics can help manage the symptoms and possibly prevent the bunion from getting worse.

3. Accommodative padding. This can help provide a cushion between the bunion and your shoe reducing pressure and friction.

4. Bunion splints. Splints can be worn to straighten the big toe and temporarily reduce pain, but they do not correct a bunion.

5. Physical therapy. Certain exercises can improve the strength and stability of the joint. Toe exercises to strengthen the joint like flexion and extension exercises of the big toe can be helpful. Towel grip exercises like trying to pick a towel off the floor with your toes may be recommended as well. Ask your doctor for specific PT recommendations given your personal circumstances.

6. Medication. NSAID's, Tylenol, injections, and ice can help reduce inflammation, swelling, and pain related to a bunion. Ask your doctor what medications are appropriate for you.

Surgical treatments

Bunions are most commonly classified as mild, moderate, severe, and arthritic.  If your doctor recommends surgery, the procedure selected is typically based on the degree of the bunion deformity.

1. Exostectomy. During this procedure, the bump or enlarged portion of bone is removed; though it’s rarely performed in isolation. Usually, the soft tissues (muscles, tendons and ligaments) surrounding the joint are balanced as well. An osteotomy or joint fusion/realignment may take place as well.

2. Osteotomy. An osteotomy involves cutting the 1st metatarsal and/or big toes bones to shift and realign the bones into a more normal position. This can correct the abnormal angle of the big toe. There are multiple ways of doing this procedure.

3. Joint fusion/realignment. This can be performed for an unstable joint and/or severe deformity. Instead of cutting part of the bones to achieve a corrected alignment, this procedure realigns the entire bone. This stabilizes the joint, but still maintains motion of the big toe joint.

4. Total joint fusion. If the big toe joint is severely arthritic or damaged, a complete joint fusion may be performed. This procedure might eliminate the pain, but will also result in complete loss of motion in the big toe joint. In some cases, a joint implant may also be used. This type of procedure would be considered an end-stage treatment. 

Ask your doctor which procedure, whether nonsurgical or surgical, is right for you. To find a doctor near you, click here.

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