A bunion occurs when abnormal alignment of the big toe pushes its base joint, the first metatarsal bone, toward the other foot. The misalignment appears as a prominent bony bump at the base of the big toe. The first symptom of a bunion might be pain at the toe joint while wearing certain shoes, followed by swelling or redness at the joint, persistent pain and potentially limited movement of the big toe.
Shoes
The Mayo Clinic states that bunions gradually develop due to abnormal motion or pressure on the metatarsophalangeal joint where the big toe meets the foot bone, and that poorly fitting shoes are often to blame. To ease the pain of a bunion and prevent it from growing worse, the Mayo Clinic recommends that you wear shoes with a wide toe box to prevent crowding of the toes and avoid tight or pointy shoes or shoes with a heel higher than 2 1/4 inches.
Bunion Pads
Most pharmacies sell bunion pads that fit around the bony bump to cushion it. Although a bunion pad will not fix the misalignment causing the bunion, it can help prevent pain, swelling and further damage to the joint.
Orthotics
Padded shoe inserts called orthotics can help properly align the toe and relieve pressure on the joint. Over-the-counter arch supports might help some people with bunions, but custom-fitted prescription orthotics might be necessary for others.
NSAIDs
Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, acetominophen, ibuprofen or naproxen, can ease the pain and swelling of a bunion. The Mayo Clinic also suggests applying an ice pack to the bunion several times a day.
Corticosteroids
Corticosteroid injections into the joint can treat bunions causing severe pain and swelling. The Merck Manual recommends a corticosteroid injection or corticosteroid plus anesthetic injection in cases where the bunion causes bursitis, which is an inflamed bursal sac at the joint, or synovitis, which is an inflammation in the lining of the joint.
Surgery
For cases of severe pain or limited mobility of the big toe due to a bunion, or for people with bunions who refuse to wear roomy shoes, The Merck Manual suggests surgery as an option. The procedure should realign the joint of the big toe and restore its normal mobility. According to the Mayo Clinic, surgical removal of a bunion involves removing the swollen tissue around the joint, removing part of the bone of the big toe to allow it to straighten, realigning the joint with the metatarsal bone and then fusing the joint to help prevent a relapse.
