Many patients describe their bunion as an enlarged bony bump on the inside of their foot at the base of the big toe. The truth, however, is that bunions are much more complicated.

Bunions, in fact, result from a gradual shift in the position and alignment of the first metatarsal, the long bone between the large toe and the instep of the foot.

As the first metatarsal gradually shifts, the visible “bump” at the base of the big toe becomes more pronounced. At the same time, the big toe begins to drift towards the second toe, and in severe cases, the second toe can end up overlapping the big toe.

What Causes Bunions?

By far, the biggest misconception among our patients is that bunions result from wearing narrow shoes, high heels, or shoes with pointed toe boxes.

While ill-fitting and unsupportive footwear can certainly worsen symptoms and accelerate the progression of this deformity, the major factor that determines whether or not you develop a bunion is your inherited foot type and structure.

If you inherit a flexible foot, you will be more prone to developing a bunion over time. Spending extended periods of time on your feet while wearing poorly supportive shoes or flip flops and going bare-footed will increase the rate at which the bunion develops. But these factors are not the root cause.

Will My Bunion Get Worse?

Bunions are considered a progressive deformity. This means they will not get better on their own, and they will only get worse if left untreated.

When bunions first appear, the bump is relatively small and the symptoms so minor that you may feel you can safely ignore them. You are still able to wear your normal shoes, participate in athletic activities, and live a normal lifestyle without much pain. But if left untreated, your bunions will only worsen.

As bunions progress, the bump enlarges and makes it more difficult to wear your normal shoes comfortably. The pressure and friction of the shoe against the deformity creates pain and swelling and can eventually cause a callus.

In some cases, the big toe joint may become stiff and arthritic, and this condition will gradually affect your balance and mobility.

If medical attention is postponed until the bunion is this severe, surgery may be the only remaining effective treatment. However, if treatment is sought at the onset of the bunion’s initial development it can usually prevent them from advancing to a more serious stage, or at least slow down their progression and minimize your symptoms.


What Are My Conservative Treatment Options?

Dr. Thomas J. Bobrowski at InStride Crystal Coast Podiatry can usually relieve the pain of a small-to-mild bunion and slow down the rate of progression by stabilizing the foot structure.

This is achieved through:

  • Shoe gear. Wearing shoes that fit properly, support your feet and arches well, and provide enough room for your toes to wiggle freely in all directions.
  • Orthotics. The root cause of most bunions is an inherited structural abnormality (flexibility within the foot), which requires prescription orthotics to properly assist in stabilizing, realigning, and supporting the foot.

In addition, we may recommend the following therapies to help manage bunion pain:

  • Padding the bunion to minimize pressure and friction and prevent painful calluses
  • Oral or topical non-steroidal anti-inflammatory medications
  • Cortisone injection

How Do I Know If I Need Surgery?

Bunion surgery is only recommended if the deformity interferes with and/or dictates your lifestyle. If your bunion keeps you from doing what you love (such as running, walking or hiking), or makes it difficult to get through your daily routine without pain, it is probably time to get it corrected.

There are several different surgical procedures used to correct bunions. Dr. Bobrowski will recommend an approach based on the severity of your bunion and your lifestyle goals.

Bunion surgery is a procedure that Dr. Bobrowski has performed routinely for many years, and his patients are highly satisfied with the long-term results.

If you think you may have a bunion, do not wait until it becomes painful to have it treated. Remember that bunions are progressive, and conservative therapy in the early stages can successfully slow down the development of this deformity and possibly prevent the need for surgery. Call InStride Crystal Coast Podiatry in New Bern at (252) 638-4700 to schedule your appointment or complete our contact form if you prefer a member of our staff reach out to you.