By Dr. Mercola
Healthy feet provide stability to your entire body, giving you the freedom to stand, walk, run and jump. If you suffer from bunions, however, you may experience less freedom of movement due to the inflammation and pain commonly associated with them.
Bunions are an inherited condition in which your metatarsal bones are displaced, thereby producing a bony protuberance, or unsightly "bump," on the outside of your big toe joint. As the joint enlarges, your big toe crowds inward toward your smaller toes, causing further discomfort and misalignment. I know about bunions personally because I have one on my left foot that had, at one time, misaligned my big toe by about 30 degrees.
Ideally, your big toe joint should be straight, but the average angle measure for most people is about 10 to 15 degrees. Anything beyond 20 degrees is considered to be a bunion and needs your attention.1 In the video above, I demonstrate some foot stretches that have been helpful in addressing my bunion. While pain medications, cortisone shots and surgery are among the standard treatment options, I suggest you consider natural alternatives to gain relief and prevent further degeneration of your big toe joint.
How Common Is Foot Pain?
A 2014 survey by the American Podiatric Medical Association (APMA), which polled 1,000 U.S. adults aged 18 and older, revealed that 83 percent of American adults experience foot pain on a regular basis. Furthermore, 51 percent of survey respondents claimed their activities were restricted by foot pain. The survey authors said:2
"While in theory U.S. adults understand the importance of foot health, they don't think about it often, and don't care for their feet as regularly as teeth, eyes or some other body parts. The majority trim their toenails, but after that, less than half adhere to other foot-care regimens. Women are more likely to care for their feet than men."
Clearly, your feet need special care. One of the easiest ways to care for them is often the most overlooked: simply taking off your shoes and socks on a regular basis and allowing your feet to breathe. Along those lines, you may be interested to know that bunions are virtually nonexistent among barefoot populations around the world.
Part of the basis for this may be genetics, but a significant factor is the type of footwear you choose and the amount of time you smother your feet inside socks and shoes, particularly shoes that are ill-fitting. Researchers involved with the APMA study stated:3
"When it comes to shoes, high heels are the No. 1 culprit of foot pain. Most women who own heels say these shoes hurt their feet, but that doesn't stop them from buying them — the average woman who owns high heels owns nine pairs! And they are pretty liberal when it comes to height — almost half say they will wear 3-inch heels or higher."
While you may not be able to go barefoot all the time, you may certainly consider doing so more often around your home and in your yard, as well as other safe areas covered with grass or sand. One of the benefits of living in Florida is my ability to go barefoot at home and on the beach, where I spend a few hours a day walking.
Common Symptoms of Bunions
Beyond the noticeable unsightly bump on the side of your big toe joint, you can recognize a bunion according to their common symptoms:
- Redness, tenderness and pain around your big toe joint
- Reduced mobility of your big toe, smaller toes and/or foot
- Joint stiffness in your big toe
- Deformity of your smaller toes and whole foot, caused by the deviation of the big toe
- Corns or calluses on the side of your foot or on other toes due to improper weight distribution resulting from the bunion
While bunions are most commonly associated with the big toe, smaller bunions, called a bunionette or tailor's bunion, can form at the base of your little toe. Much of the inflammation you experience with bunions is due to bursitis. Bursitis occurs when the small fluid-filled sac, or bursa, which is adjacent to your toe joint, becomes inflamed. As the condition progresses, and if arthritis develops, you may suffer from a deeper and more intense joint pain and stiffness.
Bunion symptoms are not only painful and bothersome, but they also can restrict your lifestyle. Most especially the presence of bunions will affect the type of footwear you may feel comfortable wearing, which can have both emotional and social implications. To accommodate your bunion, your shoes will definitely need a flexible sole and most likely a wider toe box.
Without treatment and care, your bunion could potentially enlarge to such a degree that you will have trouble finding suitable shoes to accommodate the deformity. In generations past, some bunion suffers were known to cut away a portion of their work boots to ease the pain. Thankfully, we have better treatment options available today!
What Causes Bunions?
Some of the factors promoting the development of bunions include:4
- Genetics: After analyzing data from the Framingham foot study, researchers concluded bunions and lesser toe deformities are often inherited, particularly in white men and women of European descent5
- Faulty foot structures: Having abnormal bone structures, excessively flexible ligaments or flat feet can cause bunions; feet that overpronate (roll inward more than normal) have also been indicated for bunions6
- Shoes: Shoes that are too narrow or fit poorly create an environment for the development of foot pain, including bunions; wearing high heels for prolonged periods contributes to the high incidence of bunions among women
"For many people, it may simply be a matter of wearing properly fitting shoes," says doctor of podiatric medicine Dina Stock, who is affiliated with Cleveland Clinic's Solon Family Health Center. "Be sure to choose low-heeled, comfortable shoes that provide plenty of space for your toes and the widest part of your foot."7
Three Strategies to Quickly Address Bunion Pain
If you suffer from daily bunion pain, below are three strategies you can apply today to find relief:8
1. Relieve pressure: A quick method for pain relief is to reduce the pressure over your bunion. Going barefoot as often as you can is one way, while choosing shoes with plenty of space in the toe box is another. Also, when wearing your standard footwear, you can protect your bunion by applying a piece of moleskin or a gel-filled pad to cushion it.
Particularly if you are a runner dealing with a bunion or other foot pain, you will want to take special care in selecting your shoes. I recommend you have your feet measured by a professional who can fit you with the right size shoe. Part of the exam often involves analyzing video of you running on a treadmill. You might be surprised to learn your real shoe size may not be the one you've been wearing most of your life.
Also, your feet may vary in size and width, and these differences will need to be accounted for to ensure maximum comfort. You won't regret getting a professional opinion, especially for shoes you will wear every day.
2. Increase circulation: Chiropractic treatment, foot massage, ultrasound and whirlpools can all increase the circulation to the affected area, which will help soothe painful bunions and promote healing.
3. Reduce inflammation: Applying ice packs and soaking your feet in Epsom salt can help soothe inflamed feet. Rather than take nonsteroidal anti-inflammatory (NSAID) relievers, such as Aleve or ibuprofen, I recommend you try curcumin to help reduce your body's inflammatory response related to your bunion pain. As you may know, there is an increased risk of heart attacks associated with NSAIDs, which is one of the reasons I suggest you avoid them.
I also discourage cortisone injections mainly because they are painful — the injection is made directly into an already inflamed joint — and they often do not last. Assuming you make no other changes, it's only a matter of time before bunion inflammation builds up again, making cortisone shots not worth your time or added discomfort.
Steps You Can Take to Improve Your Foot Health and Bunions
As with any medical condition, anything you can do preventatively is better and more effective than reactionary approaches. That said, if you do not regularly perform exercises or stretches focused on your feet, you may be putting yourself at risk for developing a new bunion or for having continued problems with an existing one. Two steps you can take now to help improve your foot health are:
1. Improve flexibility: Stretches that bring more flexibility to your whole foot, including the ones noted below may potentially help you prevent bunions from developing and will certainly help you cope with an existing one. The following stretches and illustrations were obtained from Harvard Medical School:9,10
Limber up: Sit in a chair with your feet flat on the floor. Lift your right leg so your foot is off the floor and use your big toe to make circles in the air, moving in a clockwise direction, for 15 to 20 rotations.
Repeat in a counterclockwise direction, then change feet.
Bottom of foot: Stand with your feet together. Step back with your right foot and leg and raise your heel as you press your toes against the ground.
You will feel a gentle stretch in the muscles on the bottom of your foot. Hold for 20 to 30 seconds, and then repeat with your other foot.
Heel exercises: Secure a resistance band around the leg of a heavy piece of furniture, such as a desk or table.
Sit in a chair directly opposite the piece of furniture and slip your foot into the other end of the band. Loop the band around your forefoot below your toes.
Perform a series of 10 to 15 stretches by pulling your upper foot toward your body while flexing at the ankle. Hold the stretch for several seconds, then relax and repeat. Change feet and repeat the sequence.
2. Strengthen your muscles: The strength of the muscles in your foot affect proper form and range of motion, factors which influence your risk of injury and bunions. In the video below, Daniel Fitzpatrick of Alternative Foot Solutions in Sydney reviews two daily exercises — heel raises and toe crunches — that will help you strengthen the muscles around your bunion.
The goal is to secure your big toe within the strength of the whole foot to prevent further displacement, while attempting to correct its misalignment.
Additional Suggestions for Dealing With Bunions
Yoga poses such as downward-facing dog and plank poses are effective for stretching and strengthening the muscles of your feet. Also, you can apply a foam roller or roll a tennis ball across the bottom of your foot to soothe aching foot muscles and promote flexibility. Grasping and picking up items such as marbles or small towels with your toes is a great way to flex your feet and promote toe dexterity.
Whole-body vibration exercise using a vibrating platform, such as a Power Plate, is an excellent addition to your fitness program. It can radically boost the effectiveness of virtually any exercise you do, including those focused on your feet. Vibration exercise is particularly useful for improving balance and circulation, areas that are directly linked to foot health.
Wearing a night splint or an orthotic shoe with a toe separator are two other options that may help decrease your bunion pain and improve your flexibility. As your toe is held in the correct position and the muscles become more flexible, the long bones in your foot should be better able to retain their proper alignment. A three-month study11 involving 30 adult females found that an orthotic shoe with a toe separator was more effective for pain relief than a night splint.
The study authors noted: "[T]he insole with toe separator significantly decreased the pain intensity … and was a good option for pain reduction." Unfortunately, neither solution proved to be effective for improving the misalignment of the big toe, but then again, the study lasted just three months. In my opinion, that is too short of a timeframe in which to expect structural changes related to a condition that has taken years to develop.
Curcumin Can Help to Naturally Reduce Inflammation
As mentioned above, curcumin, the active ingredient in the spice turmeric, is what I recommend for bunion and other foot pain. In India, turmeric is often referred to as "the spice of life" and it may very well be one of the most potent anti-inflammatories nature has to offer. As mentioned above, curcumin is much easier on your body than NSAID pain relievers.
To date curcumin has been investigated for its potential role in improving Alzheimer's disease, metabolic syndrome, Parkinson's and stroke damage. Curcumin exhibits over 150 potentially therapeutic activities, including potent anticancer properties. One of the ways it works, which is similar to vitamin D, is by modulating large numbers of your genes.
Previous research has also demonstrated that curcumin acts by inserting itself into your cell membranes where it changes the physical properties of the membrane itself, making it more orderly.12 As for its anti-inflammatory properties, curcumin can inhibit both the activity and the synthesis of cyclooxygenase-2 and 5-lipooxygenase, as well as other enzymes that have been implicated in inflammation.
A 2006 study13 found that a turmeric extract composed of curcuminoids (curcumin is the most investigated curcuminoid) blocked inflammatory pathways, effectively preventing the launch of a protein that triggers swelling and pain. For all these reasons, if you must take something for pain relief, by all means consider curcumin.
If You Love High Heels, These Tips Are for You
Since the majority of bunion sufferers are women, I want to draw your attention once again to the importance of choosing proper footwear. Notably, the APMA survey14 revealed that 49 percent of American women wear high heels, even though the majority of heel wearers (71 percent) acknowledge the shoes hurt their feet. Additionally, chronic discomfort — including the presence of bunions — has been shown to be ineffective to deter most women from wearing the tall strappy heels they say they love.
As such, it's not a surprise that nearly 40 percent of women surveyed said they continue to wear shoes they like even when they hurt their feet. For whatever reason, men do not seem to have this problem. With respect to high-heel habits, past APMA president and doctor of podiatric medicine Matthew Garoufalis stated:
"With high heels, moderation is key. It's best not to wear them every day. Daily heel wearing can cause the Achilles tendon, the strong tendon at the back of your ankle, to shrink. This increases your risk of an injury while doing activities in flat shoes, including exercise. Heel wearers should avoid heels higher than 2 inches. Wearing heels 3 inches or higher shifts body weight forward, and puts great pressure on the ball of the foot and the toes."
If you are a woman with bunions who also loves wearing high-heeled shoes, please consider these tips to help offset the harmful effects of the shoes you feel you cannot live without:15
- Wear high heels only occasionally and only for short periods of time, giving your feet ample breaks between wearings
- Choose a shoe with a moderate heel height and wide heel base (i.e., wedge heel)
- Use a shoe insert to reduce pressure on the forefoot and heel when wearing high heels16
- Stretch your calves every day to maintain ankle flexibility
- Wear flat shoes or tennis shoes if you must walk long distances during the day, such as to and from the train station to your office, for example
You Need Your Feet for a Lifetime
The bottom line is that you need your feet for a lifetime. So much of your vitality and livelihood depend on the proper functioning of your feet, so it's best to take good care of them. Although your doctor may suggest anti-inflammatory drugs and cortisone shots for pain relief or surgery, keep in mind there are no "quick fix" solutions to bunions.
I believe surgery is the very last resort you should consider, after trying natural remedies first. While a surgical procedure may correct the anatomical structure of your big toe, it will not address the underlying condition that caused the bunion in the first place. For this reason, it is possible for a surgically altered big toe to become misaligned years after the surgery, especially if you continue with the bad habits that contributed to your bunions in the first place.
I have been treating my bunion for several years. Fortunately, treatments have reduced my level of pain and discomfort, and most notably, have nearly curtailed the changes the bunion had been making to my foot. While conventional doctors will tell you bunions are permanent unless you have them surgically corrected, I recommend you start with less-invasive treatments. With steady effort, you can reduce your level of pain and discomfort, slow or stop the progression, and improve the flexibility of your foot and other joints.