How to Prevent Development of a Bunion

Early intervention helps prevent bunions.

Bunions are one of the most common complaints patients report to podiatrists, according to Paul Langer, DPM. If not properly treated in the early stages of development, a bunion (Hallux valgus) can progress into a very painful and debilitating foot disorder. Early intervention helps prevent further development of bunions or bunion pain and the need for bunion surgery or a bunionectomy.

Instructions

Prevention

1. Bunions develop over time, and sometimes without bunion pain, so watch for physical signs of a bunion. Early symptoms include the big toe moving towards the smaller toes, red inflammation and a bump on the base joint of the big toe, and other foot deformities such as hammertoe and claw toe.

   Discomfort from a bunion may be stiffening in the big toe base joint (arthritis) or pain on the top or side of the big toe from shoe pressure. However, in general, bunion pain is a deep, dull "in the joint" pain and that can interfere with everyday activities.

2. Identify the severity of a bunion prior to treatment by referring to the Manchester scale, which measures the medial deviation of the metatarsophalangeal (MTP) joint with respect to the big toe. The scale consists of standardized photographs of feet with four grades of Hallux valgus: none---mal-positioning is less than 20 degrees ; mild -- mal-positioning is between 20 and 30 degrees; moderate---mal-positioning is between 30 and 50 degrees; severe -- mal-positioning is more than 50 degrees.

3. Intervene early if the mal-positioning is mild (less than 30 degrees) by wearing a flexible splint and exercising feet daily. Wear a bunion splint that stabilizes the metatarsal arch and pulls the big toe away from the smaller toes, preferably while walking, so the correction of the bunion occurs through the range of motion. According to Dynamic Chiropractic, a foot that is developing a bunion must have good support for the medial longitudinal arch and allow flexing of the first metatarsal joint while walking. The American Orthopaedic Foot and Ankle Society recommends frequent, simple foot exercises to avoid common foot disorders such as bunions and hammertoes.

4. Consult a medical professional prior to wearing a bunion splint if the degree of severity is moderate. To help alleviate bunion pain, wear mid-foot arch support to stabilize the metatarsal bones and a metatarsal pad to redistribute pressure away form the painful bunion while wearing shoes.

5. If the bunion is severe, consult a medical professional about the various types of surgery and the associated risks. If a bunion surgery (bunionectomy) is performed, wear a bunion splint for post-surgical rehabilitation, and on an ongoing basis, to help prevent recurrence of the bunion.

Tips & Warnings

• The American Orthopaedic Foot & Ankle Society recommends against wearing shoes with pointed toes and high heels because they squeeze the toes and increase pressure on the big toe, significantly contributing to further development of a bunion. Wearing wide-toe boxed shoes with heels less than 1-1/2 inches high is essential to preventing further development of a bunion, regardless of the degree of severity.

• If you will be walking in a bunion splint, it must be manufactured with a fatigue-resistant material that can bear weight under load and allow flexing of the big toe. Otherwise, there is high risk the splint will crack.

• Diabetics should avoid wearing bunion splints due to the possible constriction of blood circulation.

References

• "Great Feet for Life," Paul Langer, DPM, Copyright 2007, pg.87
• Study: Self-assessment of hallux valgus using the Manchester scale
• Dynamic Chiropractic: Orthotics for bunions
• American Orthopaedic Foot and Ankle Society: Recommended foot exercises
• American Orthopaedic Foot and Ankle Society: Opinion on foot wear

Resources

• Read this Article in Spanish
• Alpha Orthotics: What is Hallux valgus?
• Mayo Clinic: Symptoms
• Study: Dynamic splint for mild to moderate bunions