What is a Bunion?
A bunion is a common condition that develops slowly and results from the gradual dislocation of the big toe joint. It usually starts as an inflammation that becomes a swollen, red bump in and around the big toe joint. Bursitis (a painful inflammation of the fluid-filled sac that surrounds and protects joints) may precede or accompany a bunion. If left untreated, a bunion will often become more severe. Once fully developed, bunions are usually not painful, unless osteoarthritis or corns and calluses have developed as a result.

What Causes Bunions?
The underlying cause is a bio mechanical problem of abnormal pronation (rolling in of the feet in toward each other). This force gradually causes a rotational dislocation of the big toe joint. This condition is usually hereditary. It is not uncommon to see three generations of a family with the same type of bunion problems. Regularly wearing pointed-toe and high-heeled shoes will, however, greatly aggravate and accelerate bunion development. Obesity and having to stand for long periods of time can also contribute to bunion formation.

What Should I Do if a Bunion is Starting to Form?
A bunion is difficult to completely prevent because the force causing it is great. There are some things you can do, however, to slow down it progression and to provide some relief from any discomfort.

• Wear proper-fitting shoes that don't pinch the toes or have high heels. Hosiery shouldn't be tight on the toes either.
• Do exercises to straighten the toe joint. With your fingers or with your other big toe, gently pull the big toe back into proper alignment. Or, put both big toes inside a wide elastic band and gradually move your feet apart.
• A toe splint or straightener can be worn at night.
• Properly designed orthotic shoes may alleviate the underlying bio mechanical problem.

What Can I Do To Relieve Bunion Pain and Inflammation?

• Soak feet in warm (not hot) water with Epsom Salts for 15 minutes to provide temporary relief from pain and inflammation. An ice pack used by itself for 15 minutes or alternating with the warm soak may help further.
• Bunion protection pads are sometimes helpful in reducing pressure on the bunion. Adhesive moleskin pads should never be placed on the skin, but rather on the inside of the shoe. Gel pads are the easiest to use, but they should not be placed over broken skin. Cut out adhesive foam can be used if surrounding skin is intact.
• Wear "bunion" shoes available from orthopedic stores. Some of the new designs are quite attractive.

Should I See My Doctor or a Podiatrist?
See your physician if the bunion is becoming worse despite self-treatment. Other conditions such as osteoarthritis, gout, and infection may be causing the pain and inflammation and need to be ruled out. Your doctor or the podiatrist may be able to provide temporary relief through non-surgical means such as physiotherapy and anti-inflammatory medications. Surgery is the only "cure" for bunions. If surgery is an option for you, it is better to have it done before the bunion is too severe.