A bunion is a bump on the medial side of the foot at the base of the big toe. This is a condition often characterized by spreading of the metatarsals and drifting of the big toe toward the other toes. Bunions are more common in women, with the most common causes being hereditary and poor footwear. Symptoms include pain along the medial side of the foot over the bunion, most notably when there is pressure on the bump due to tight shoes. Some individuals develop a callus on the ball of the foot as a result of the weight being transferred to the second toe.
Non-surgical treatment options include medication, altering footwear, and physical therapy. It is recommended to choose wider footwear to alleviate the pressure on the bunion that could further increase the angle at the first MTP joint. Toe spacers may help with mild deformities to decrease the angulation of the toes or the progression of the bunion. Your physician may prescribe NSAIDs to decrease inflammation. Physical therapy interventions include stretches to maintain flexibility of the great toe and foot, strengthening of the great toe, and gait activities to maintain the proper mechanics of the foot.
When non-surgical options have been exhausted, surgery may be indicated to correct the alignment of the first metatarsal and big toe. Depending on the severity of the bunion, your surgeon will choose the proper technique to correct the deformity. Post- operatively, it is important to return to wearing properly fitting footwear. Physical therapy may be prescribed post-surgically to restore range of motion and flexibility of the great toe and foot.
Caitlin Niemeier, MPT