Why Do Bunions Hurt?

If you have bunions, there’s a pretty good chance they’ve caused you pain, whether it’s constant or on occasion. Foot pain can be a major setback in staying active and fully involved in your own life.
Find out why those pesky bunions are causing you grief and learn what you can do about it. If you’ve notice a change in your quality of life due to foot pain from bunions, it’s definitely time to seek help!

What are bunions?

Bunions, also known as hallux valgus, are known best for the large bump that forms at the base of your big toe joint.1 This knobby joint is a result of the big toe gradually moving toward the other toes, causing the toes appear smashed together.

This toe alignment can be stagnant or gradually get worse with time, depending on what is causing it. Regardless of the cause, bunions can make it hard to find comfortable shoes and are notorious for causing redness, pain and swelling of the affected big toe joint.


What causes bunions?

Bunions are the most common foot problem in the U.S., no matter the age or gender.2 However, it is most common in the middle aged population from “overuse” of the joint. It can affect both feet but typically affects one side more than the other.
Commons causes for bunions include genetics, unnecessary strain on the big toe due to stiff feet or ankles, generalized poor lower extremity mechanics, and medical conditions like rheumatoid arthritis. Very common outside factors that can also cause or further progress bunions include wearing high heels and ill-fitting shoes.

Thus, it tends to affect women more than men because of their typical choices of shoe wear. No matter the reason, the poor alignment associated with bunions can get worse and more painful without proper attention to the structure of your foot and ankle and how it ties into the way you move.

Medical concept. Foot pain. Body health problem, healthy feet swollen joints or blisters, wounds on skin. Painful barefoot woman at home or office with high heels in the background

An overlooked common cause: Foot stiffness causing faulty mechanics.

One of the most common causes of bunions that is not often considered is stiffness of the ankle. This stiffness impedes the ability to complete dorsiflexion (bring the toes toward the shin), a motion essential for proper daily activities such as walking, squatting and even standing.

When the ankle is too stiff to complete this basic movement, it must find a new way to get the motion it needs so you don’t walk like a robot. Thus, typically the entire leg will rotate slightly (toes and knee cap are pointed out more than usual) so that the lower leg can essentially “roll” over the middle foot and toe.

You can imagine that with time this will put major strain on the foot, particularly the big toe, and start causing long term mechanics and alignment changes. This is just one of many ways that the body can adjust itself to preserve your ability to move. Other common issues that can cause poor foot mechanics and bunions include a stiff knees and/or hips.

Treatment options for bunions.

A good physical therapy program can help you properly address mechanics of the feet, ankles, knees and hips.  Plus, you’ll learn ways to effectively manage any pain flares and promote the best possible balance of strength and flexibility in your entire lower body.

Having a trained eye observe the way you move and assess your full body coordination will result in a custom program that will optimize your daily mechanics and take strain off your toe.

physical therapy bunions

Specific treatment options may include, strengthening exercises, stretching, joint mobilization, foot wear recommendations,  kinesiotaping, modalities, and so much more.3,4
The key will be to effectively manage your pain while attempting to better align (or prevent progression of the mal-alignment) of the big toe.

Other potential options.

Research related to bunion treatment mainly revolves around surgery in addition to special shoe wear, splinting and casting. Of these options, surgical intervention to essentially realign the toe is the only one shown to be superior to no treatment (particularly with severe cases).5
There are all kinds of shoe wear, socks, braces and the likes out there claiming that they can correct your bunions.

Tread carefully and consider discussing if any of these options can help you with your orthopedist, podiatrist or physical therapist. If you do proceed with surgery, physical therapy afterwards is still a great option for optimizing your recovery and addressing any underlying issues with your foot that could linger after the procedure.

For anyone with bunions, the weakest link is your toe.

The truth is that painful bunions may just be the tip of the iceberg for your faulty movement patterns. Typically, our bodies do their best to adjust to any maladaptive anomalies or habits, until somewhere in the body the “weakest link” starts putting up a fight.

For anyone with bunions, the big toe is the joint waving a red flag that you need to get your body in gear and better balance. Basically, the body has been abusing the toe for too long because it was the easiest way for you to adjust without expending too much thought or energy.

Couple of lovers walking on the each at sunset - Foot prints on the beach

However, unfortunately now you’re paying for it. This is why having a trained professional that looks at your function as a whole, rather than only looking at your toe, can help you make the gains you want quickly.

Let your physical therapist be your bunion guide.

No matter the cause or pain you are experiencing, treatment can be simple and effective to keep you on track and literally “on your toes.” Talk to a trusted physical therapist today to maximize your daily activities without pain through strengthening, stretching, coordination and so much more.

When it comes to bunions, don’t settle for less than you are capable of because of pain flares that you can prevent or manage with the right help.

Why Do Bunions Hurt infographic

How Grace reduced her ankle pain and inflammation

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