Bunions: Causes, Symptoms, and Treatments Explored

How can one effectively manage the early signs of bunions?

Bunions

A bunion, also known as hallux valgus, is a bony, often painful protrusion on the side of the big toe. The most common cause of bunions is a misalignment of the big toe. Early symptoms of a bunion include redness, thicker skin, edema, and discomfort around the big toe joint. While you can’t stop a bunion from growing, you can manage the symptoms along the way. Early indicators of bunions include pain management measures and treatment choices. (MedlinePlus, 2024)

Early Visual Signs

Bunions are initially minor and don’t result in many noticeable issues. The following symptoms may be present in the early stages of a bunion around the metatarsophalangeal (MTP) joint, which joins the base of your big toe to the rest of your foot. (American Academy of Orthopaedic Surgeons, 2022)

• Redness
• Skin that is darker and swollen
• Skin that has gotten thicker and harder
• There is a bony bump
• A bump where the big toe goes toward the second toe or even under it
• Corns and calluses

Early Physical Signs

While bunions may not be visible immediately, they can cause discomfort even in the early stages. Here are some early physical indicators of a developing bunion. (MedlinePlus, 2024)

• Pain in the foot and big toe
• This pain is especially noticeable when walking or wearing tight, narrow-toed shoes.
• Decreased movement of the big toe
• Tenderness
• Inflammation
• Swelling
• Stiffness
• Heat

Stages

Bunions often worsen over time, a condition known as progressive. You could have problems if you don’t do anything to stop your bunions from getting bigger. Bunions in later stages might cause the following symptoms: (American Academy of Orthopaedic Surgeons, 2022)

• Long-lasting, intense pain in and around the MTP joint and the sides and bottom of your foot
• Bursitis causes a sac full of fluid to form at the bottom of your big toe.
• The big toe bends toward and even crosses over the second toe.
• Too much bone development on the side of your big toe
• Not being able to wear your regular shoes
• Hard to walk
• Abnormalities known as “hammer toe” occur when your second, third, or fourth toes bend upward in the middle, resembling a hammer or claw.
• Hallux rigidus is a form of arthritis affecting the big toe.

Manage the Progression

Bunions tend to remain in place once they start to develop. However, there are several steps you can take to prevent them from worsening or causing additional problems. These are some of them: (American Academy of Orthopaedic Surgeons, 2022)

• Avoid ill-fitting shoes and high heels.
• Wearing orthopedic footwear and/or wide, comfy, soft-soled, low-heeled shoes is recommended.
• Place spacers between your toes to prevent friction and chafing.
• Use over-the-counter (OTC) pads made of felt, silicone, or foam to cover the bunion.
• You should also stretch your calf muscles to improve joint alignment.

Managing Pain

Advil and Motrin (ibuprofen) are two examples of non-steroidal anti-inflammatory medicines (NSAIDs) that can aid with bunion pain. Studies also show that injecting Botox into the muscles in the forefoot can help with pain. (Hurn, S. E., et al., 2022)

Nonsurgical Early Stage Treatment

If your bunions continue to worsen despite using the self-care procedures listed above, you may need to consult a podiatrist (a foot expert) or another healthcare provider. A healthcare provider may recommend.

Orthotics, or foot orthoses

• Foot orthoses, also known as orthotics, are customized inserts that help alleviate bunion pain and prevent chafing.

Splints

• Bunion splints are orthotic devices that can help straighten out your toes. People typically use them at night. (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 line up better. They might also do manual therapy to help with pain. (Hurn, S. E., et al., 2022)

Podiatrist

A podiatrist is a medical doctor (M.D.) who specializes in treating health problems that affect the feet, ankles, and lower legs. If you want help with your bunion issues, ask your doctor for a referral to a podiatrist. (American Podiatric Medical Association, 2025)

Chiropractic Treatment

Chiropractors and nurse practitioners (NPs) have distinct roles in managing bunions, which are bony bumps at the base of the big toe caused by joint misalignment, often resulting in pain, swelling, and restricted movement. Here’s how each can help:

Chiropractors:

• Focus: Chiropractors primarily address musculoskeletal issues through manual adjustments and manipulations.
• Bunion Support:
  • Foot Adjustments: They may perform adjustments to improve foot alignment and joint mobility, which can potentially reduce bunion-related discomfort.
  • Soft Tissue Therapy: Techniques such as massage or myofascial release can help alleviate tension in surrounding muscles and tissues.
  • Orthotics or Taping: Some chiropractors recommend custom orthotics or use taping to support proper foot mechanics.
  • Exercise Guidance: They may suggest stretches or exercises to strengthen foot muscles and improve alignment.
• Limitations: Chiropractors don’t prescribe medications or perform surgeries, so severe cases requiring these interventions would need referral to a podiatrist or orthopedic specialist.
• Evidence: While some patients report relief from chiropractic care for foot issues, evidence specifically for bunions is limited, and results vary.

Nurse Practitioners:

• Focus: NPs are advanced practice registered nurses with broad medical training, able to diagnose, treat, and prescribe medications within their scope of practice.
• Bunion Support:
  • Diagnosis and Assessment: NPs can evaluate bunion severity, often using physical examinations or ordering imaging, such as X-rays, to assess joint damage.
  • Pain Management: They may prescribe anti-inflammatory medications (e.g., ibuprofen) or corticosteroid injections for pain and swelling.
  • Conservative Treatments: NPs can recommend padding, splints, or orthotic devices to reduce pressure and improve alignment.
  • Lifestyle Advice: They provide guidance on footwear (such as wide-toed shoes) and weight management to reduce stress on the bunion.
  • Referrals: For severe cases, NPs can refer patients to podiatrists or orthopedic surgeons for surgical options, such as bunionectomies.
• Scope: NPs offer a medical approach, bridging conservative care and coordination with specialists.

Key Differences:

• Chiropractors focus on non-invasive, manual techniques and alignment, while NPs can incorporate medications and broader medical management.
• NPs are more likely to coordinate with other healthcare providers for comprehensive care, whereas chiropractors tend to work more independently.

General Notes:

• Both can assist in managing mild to moderate bunion symptoms, but neither can “cure” bunions, particularly if the structural deformity has progressed.
• Consult a podiatrist or an orthopedic specialist for persistent or worsening symptoms, as severe cases may require surgical intervention.
• Always verify the provider’s credentials and experience in treating bunions.

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a nurse practitioner, treats a wide range of conditions using a combination of medical knowledge and chiropractic care. The clinic offers personalized care plans that incorporate functional medicine, acupuncture, electroacupuncture, and sports medicine. The clinic treats chronic pain syndromes and injuries, focusing on strength, agility, and flexibility. Comprehensive care plans, when paired with in-person and virtual health coaching, offer personalized treatment and wellness outcomes for patients of all ages and abilities.

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