Bunions

What Your Symptom Is Telling You

This is the story of Paul Bunion—not the massive, axe-wielding lumberjack of literary legend (actually spelled Bunyan), but the large bump on your big toe joint.

Mr. Bunion has probably been with you from birth—many doctors say the propensity toward bunions is inherited. The reason he suddenly (it seems) came out swinging: You've been wearing shoes that are too tight.

As you get older, tight shoes can actually cause extra bone growth and the development of a fluid-filled sac on the toe joints on either side of your foot. And that's enough to make the joints bulge and ache, cause erosion of the surrounding cartilage or even put painful pressure on the rest of your toes, says Michael Coughlin, M.D., past president of the American Orthopedic Foot and Ankle Society and an orthopedic surgeon in Boise, Idaho.

Symptom Relief

To beat bunions, try these tips.

Stretch those shoes. If your favorite pair of shoes is causing or irritating the bunion, take them to a shoe repair store and have them stretched, or do it yourself with a device that's available for under $10 at most drugstores, says Myles Schneider, D.P.M., an Annandale, Virginia, podiatrist and coauthor of the book How to Doctor Your Feet without a Doctor.

Slip into some sandals. If your dress code is more relaxed, consider wearing sandals or even going barefoot, says Steve Guida, D.P.M., a Fort Lauderdale, Florida, podiatrist who's treated hundreds of older patients. A more open shoe means less binding and, as a result, less opportunity for bunion discomfort, he says.

Shield yourself. Pads called bunion shields can serve as a comfortable barrier between you and your shoes, Dr. Guida says. After the shield has been placed directly on the bunion, adhesive on the back keeps it in place. For long-term use, try bunion shields made of silicone, says Dr. Guida. Both kinds are available at drugstores.

Shine those shoes. Some shoe polishes applied once a week can soften shoe leather, which may help your favorite pair relax to the shape of your bunion rather than press against it, says Dr. Schneider.

Exercise those bunions. The following exercise helps loosen the stiffness that often accompanies bunions, says Dr. Schneider. Using a 1-inch-by-18-inch piece of cotton cloth or a thin rope, tie a loop and place one end around each big toe. While keeping your heels on a flat surface with the cloth or rope extended between the feet, gently pull the toes apart and hold for five seconds. Repeat 10 times, says Dr. Schneider. Increase this routine by one repetition each day until you can do 25.

Give orthotics a try. Custom-made arch supports called orthotics may also help relieve the pain by reducing the amount of foot motion in the shoe. Expect to pay $50 for one made of hard rubber and $350 and up for one made of graphite, says Dr. Coughlin.

Customize your footwear. Shoes made with your bunion in mind should never bind or irritate that delicate area, says Dr. Guida. Pedorthists—skilled craftspeople who specialize in making shoes for folks with foot problems—charge from $300 to $500 for a pair, according to Dr. Guida. Before beginning their work, pedorthists take a plaster impression of your foot and then build a shoe around it, says Charley Simpson, a certified pedorthist and former owner of Simpson Shoes in Boston.

Consider a bunionectomy. If the pain continues despite your best efforts, you might want to consider a bunionectomy. During this procedure, the doctor may remove some of the bone that's causing the discomfort and tighten the joint—or even replace it. Surgery should always be the last resort, says Dr. Coughlin.