Bunions and Their Impact on Foot Health

What are the potential strategies for addressing the initial symptoms of bunions?

Bunions

A bunion, or hallux valgus, is a bony and frequently painful protrusion on the lateral aspect of the big toe. The predominant cause of bunions is the misalignment of the big toe, known as the hallux. Initial indications of bunions encompass erythema, hyperkeratosis, edema, and sensitivity surrounding the metatarsophalangeal joint of the hallux. While we cannot reverse the progression of a bunion, we can manage its symptoms throughout the process. The initial indicators of bunions encompass pain management techniques and diverse therapy alternatives. (MedlinePlus, 2024)

Initial Visual Indicators

Initially, bunions are small and do not cause many apparent problems. The symptoms of a bunion may be observed in the vicinity of the metatarsophalangeal (MTP) joint, which connects the base of the big toe to the remainder of the foot, during the early stages of the condition. (American Academy of Orthopaedic Surgeons, 2022)

• Redness
• The patient presents with swelling and skin discoloration.
• Hard skin that has thickened
• There is a bone lump.
• Prominence where the big toe slides toward or under the second toe
• Calluses and corns

Early Physical Symptoms

Bunions may not be immediately apparent. However, they can induce discomfort even in their initial stages. Here are initial physical indicators of an advancing bunion. (MedlinePlus, 2024)

• Pain in the foot and big toe
• When wearing tight, narrow-toed shoes or walking, this soreness is more apparent.
• Decreased movement of the big toe
• Tenderness
• Inflammation
• Swelling
• Stiffness
• Heat

Stages

Bunions often worsen over time, a condition known as progression. You could end up with problems if you don’t stop your bunions from getting worse. In their later stages, bunions can cause the following signs and symptoms: (American Academy of Orthopaedic Surgeons, 2022)

• Extreme, persistent discomfort in the metatarsophalangeal joint (MTP) and throughout the foot.
• A bursa, a sac filled with fluid, can develop near the base of your big toe due to bursitis.
• Your big toe flexes toward and sometimes even crosses over your little toe
• Excessive bony expansion on the side of the big toe
• Discomfort in wearing your usual footwear
• Struggling to walk
• A hammer toe is a deformity in which the middle toes of the affected foot flex upwards, giving the foot a claw or hammer shape.
• Hallux rigidus is the medical term for arthritis of the big toe.

End the Continuation

As soon as bunions start to form, they tend to remain that way. However, there are steps you can take to stop them from escalating or intensifying the current issues. These are some (American Academy of Orthopaedic Surgeons, 2022)

• Preventing the use of high platforms and ill-fitting shoes
• Wearing low-heeled shoes and/or broad, comfortable, soft-soled, and orthopedic footwear
• Using spacers between your toenails to prevent chafing and rubbing
• Utilizing over-the-counter (OTC) cushions composed of silicone, foam, or felt to conceal the bunion
• Enhancing joint alignment by stretching your calf muscles

Dealing with Pain

Anti-inflammatory drugs (NSAIDs), like Advil or Motrin (ibuprofen), and ice packs can help ease the pain of a bunion. Studies have also shown that injecting Botox into the muscles in the feet may help alleviate pain. (Hurn, S. E., et al., 2022)

Early Stages of Nonsurgical Treatment

You may require treatment from a podiatrist (foot specialist) or another healthcare provider if your bunions continue to worsen despite the self-care measures you have taken. A healthcare provider may suggest

Foot Orthoses, also called Orthotics

• Orthoses, also known as foot orthoses, are carefully crafted inserts that prevent chafing and alleviate the pain associated with bunions.

Splints

• A bunion splint is an orthotic device that helps straighten your toes, typically worn at night to provide relief from bunion pain. (Aebischer, A. S., & Duff, S. 2020)

Physical Therapy

• A physical therapist can help you by giving you exercises that will help your feet and joints move more smoothly. To help with pain, they may also use manual treatment. (Hurn, S. E., et al., 2022)

Podiatrist

A podiatrist is a type of medical doctor (M.D.) who specializes in treating problems with the feet, knees, and lower legs. Talk to your doctor about seeing a podiatrist if you need help dealing with the signs of your bunion. (American Podiatric Medical Association, 2025)

Chiropractic Treatment

A chiropractor and nurse practitioner (NP) can play complementary roles in managing bunions for athletes or those involved in sports, addressing both symptoms and underlying biomechanical issues. Here’s how each can help:

Chiropractor:

• Biomechanical Assessment and Correction: Chiropractors can evaluate foot mechanics, gait, and lower body alignment, as bunions are often linked to improper foot function or overpronation. They may identify issues such as flat feet or ankle instability that can exacerbate bunions.
• Adjustments: Spinal or extremity adjustments (e.g., to the foot, ankle, or pelvis) can help improve alignment and reduce stress on the foot, potentially slowing the progression of bunions.
• Soft Tissue Therapy: Techniques such as myofascial release or massage can alleviate pain in the foot and surrounding areas by reducing muscle tension and improving blood circulation.
• Custom Orthotics: Chiropractors may recommend or provide custom orthotic inserts to support proper foot alignment, redistribute pressure, and reduce strain on the bunion during sports activities.
• Exercise and Stretching: They can prescribe specific exercises to strengthen foot muscles (e.g., toe curls, arch strengthening) and improve flexibility, which can help stabilize the foot and reduce discomfort.

Nurse Practitioner:

• Medical Evaluation and Diagnosis: NPs can assess the severity of the bunion, check for complications (e.g., bursitis, arthritis), and rule out other conditions (e.g., gout, fractures) that may mimic bunion symptoms.
• Pain Management: They can prescribe or recommend anti-inflammatory medications (e.g., ibuprofen) or corticosteroid injections for acute pain or inflammation, which is especially helpful for athletes needing quick relief to stay active.
• Wound Care and Infection Prevention: If the bunion causes skin irritation, blisters, or calluses from sports footwear, NPs can provide guidance on wound care or treat infections, ensuring athletes avoid downtime.
• Referral Coordination: NPs can refer patients to podiatrists or orthopedic surgeons if the bunion requires advanced interventions, such as surgery, and they can coordinate care for holistic management.
• Lifestyle and Preventive Advice: NPs can educate athletes on proper footwear (e.g., wide-toe-box shoes), weight management to reduce foot stress, and strategies to prevent bunion worsening.

Collaborative Approach:

• A chiropractor and an NP can collaborate to create a comprehensive treatment plan. For example, the chiropractor addresses biomechanical issues and provides non-invasive therapies, while the NP manages pain, monitors for complications, and oversees medical needs.
• For athletes, interventions can be tailored to maintain performance, such as recommending sport-specific shoes, taping techniques, or modified training schedules to reduce stress on the bunion.
• They may also advise when to rest or modify activities to prevent further damage, ensuring the athlete can return to their sport safely and effectively.

Limitations:

• Neither can perform bunion surgery (typically done by a podiatrist or orthopedic surgeon), but they can help manage symptoms conservatively and delay or avoid the need for surgery.
• Severe bunions causing significant deformity or pain may require specialist intervention beyond their scope.

Practical Steps for Athletes:

1. Consult Both Professionals: See a chiropractor for a biomechanical assessment and a nurse practitioner (NP) for a medical evaluation.
2. Footwear: Use wide, supportive athletic shoes with orthotics as recommended.
3. Pain Relief: Follow the NP’s guidance on medications or ice therapy after activity.
4. Strengthening: Do foot exercises prescribed by the chiropractor to improve stability.
5. Monitor Progress: Conduct regular check-ins with both parties to adjust the plan as needed.

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a nurse practitioner, utilizes chiropractic care in conjunction with medical expertise to address a wide range of conditions. The clinic offers personalized care programs that combine functional medicine, acupuncture, electroacupuncture, and sports medicine. The clinic emphasizes the importance of agility, flexibility, and strength in treating chronic pain syndromes and injuries. Individualized wellness outcomes and treatment plans are guaranteed for patients of all ages and abilities through the implementation of comprehensive care plans, as well as in-person and virtual health coaching.

Enhance Your Performance with Functional Foot Orthotics

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