Bunions: Early Detection and Pain Relief Strategies

What are some effective ways to address the initial signs of bunions?

Bunions

As the name suggests, a bunion is a firm bump on the side of the big toe that is often painful. The most common cause of bunions is a misalignment of the big toe. Some of the first signs of bunions are redness, thicker skin, swelling, and pain around the joint of your big toe. You can’t stop a bunion from getting worse, but you can control the pain as it happens. Some of the first signs of bunions are ways to deal with pain and different treatment choices. (MedlinePlus, 2024)

Early Signs You Can See

Bunions first present as minor and do not result in significant issues. In the initial phases of a bunion, you may observe the following symptoms surrounding the metatarsophalangeal (MTP) joint, which links the base of your big toe to the remainder of your foot. (American Academy of Orthopaedic Surgeons, 2022)

• Erythema
• Edema Hyperpigmentation
• Hyperkeratotic skin
• A bony protrusion exists
• Prominence where the hallux deviates toward the second digit or beneath it
• Callosities and corns

First Physical Signs

Bunions can cause discomfort early on, but they may not be visible. Here are some early physical signs that a bunion is getting worse: (MedlinePlus, 2024)

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

Stages

One common symptom of bunions is that they tend to worsen with time. Bunions can become problematic if you don’t take action to prevent them from worsening. The following symptoms characterize bunions in their late stages: (American Academy of Orthopaedic Surgeons, 2022)

• Prolonged, intense pain in the areas surrounding the MTP joint, as well as on the sides and bottom of your foot
• A fluid-filled sac forms at the bottom of your big toe due to bursitis.
• Your big toe is bending over your second toe and possibly crossing it.
• Overgrowth of bone along the side of your big toe
• Unable to put on your usual shoes
• Walking with difficulty
• When your second, third, or fourth toes flex upward in the middle, it’s known as a “hammer toe” deformity.
• The big toe arthritis, called hallux rigidus

Stop the Development

When bunions begin to form, they won’t go away. But don’t worry, there are several strategies to prevent them from worsening or creating further problems. Among them are (American Academy of Orthopaedic Surgeons, 2022)

• Not wearing shoes that don’t fit right and high heels
• Putting on orthopedic shoes or shoes that are wide, comfy, soft-soled, and low-heeled
• Putting spacers between your toes to keep them from rubbing together and hurting
• Putting over-the-counter (OTC) pads made of felt, silicone, or foam over the bunion
• By stretching your leg muscles, you can increase the stability of your joints.

Management of Pain

You can alleviate the pain of a bunion with the use of an ice pack or an NSAID, like Advil or Motrin (ibuprofen). Botox injections into the muscles of the forefoot have also been shown to alleviate pain, according to studies. (Hurn, S. E., et al., 2022)

Treatment for Early Stages Without Surgery

Take the above steps to care for your bunions. Still, if they continue to worsen, you may need to consult a podiatrist (a specialist in foot care) or another medical professional. A health care provider may say

Personalized orthotics for the feet

• Orthoses, often referred to as foot orthoses, are inserts designed to alleviate bunion pain and reduce friction.

Splints

• Nighttime use of orthotic devices, such as bunion splints, can help straighten the toes and alleviate discomfort.(Aebischer, A. S., & Duff, S. 2020)

Physical Therapy

• To alleviate your foot and joint pain, a physical therapist might prescribe exercises to help you achieve better alignment. As an additional pain-relieving measure, they may employ manual therapy. (Hurn, S. E., et al., 2022)

Podiatrist

Foot, ankle, and lower limb disorders are the specialty of a medical doctor (M.D.) known as a podiatrist. To get assistance with bunion pain management, consult a podiatrist or ask your primary care physician for a recommendation. (American Podiatric Medical Association, 2025)

Chiropractic Treatment

A chiropractor and a nurse practitioner can play complementary roles in managing bunions (hallux valgus), a painful deformity of the big toe joint, although their approaches differ based on their respective expertise. Here’s how each can help with personal injury-related bunion care:

Chiropractor

Chiropractors focus on musculoskeletal health, particularly alignment and biomechanics, which can be beneficial for bunions caused or worsened by poor foot mechanics or injury.

• Assessment and Diagnosis: A chiropractor can evaluate foot structure, gait, and biomechanics to identify factors contributing to bunion pain, such as overpronation, flat feet, or misalignment in the foot, ankle, or lower body. They may assess how an injury (e.g., trauma to the foot) has impacted bunion development or severity.
• Manual Adjustments: Chiropractors may perform adjustments to the foot and ankle to improve joint mobility and alignment. For example, they might manipulate the big toe joint or other foot bones to reduce stress on the bunion and improve function.
• Soft Tissue Therapy: Techniques such as myofascial release or massage can help address tight muscles, tendons, or ligaments surrounding the bunion, thereby reducing pain and inflammation. This is especially helpful if the injury has caused compensatory tension in the foot.
• Orthotics and Support: Chiropractors may recommend or fit custom orthotics to resolve biomechanical issues, such as excessive pronation, which can exacerbate bunions. Orthotics can redistribute pressure away from the bunion, reducing pain during movement.
• Exercises and Stretches: They can prescribe specific exercises to strengthen foot muscles (e.g., toe spreaders, arch-strengthening exercises) and improve flexibility, which may help slow the progression of bunions and alleviate discomfort. For example, towel scrunches or marble pickups can strengthen intrinsic foot muscles.
• Lifestyle Advice: Chiropractors often recommend footwear, suggesting wide-toe-box shoes or avoiding high heels to prevent further irritation of the bunion, especially after injury, when the foot may be more vulnerable.

Nurse Practitioner

Nurse practitioners (NPs) provide medical care, including diagnosis, treatment, and coordination of care, with a focus on holistic patient management. Their role is more medically oriented and can address both the bunion and any injury-related complications.

• Medical Evaluation: An NP can assess the bunion’s severity, check for complications (e.g., bursitis, arthritis, or infection), and evaluate how a personal injury (e.g., fracture, sprain, or trauma) may have aggravated the condition. They may order imaging (e.g., X-rays) to rule out fractures or assess joint damage.
• Pain Management: NPs can prescribe medications like nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, especially if the bunion is inflamed due to injury. They may also recommend or administer corticosteroid injections for severe inflammation, though this type of therapy is less common.
• Wound Care and Infection Control: If the bunion has developed blisters, calluses, or open sores (common with irritation or post-injury swelling), an NP can provide wound care and prescribe antibiotics if infection is present.
• Referral to Specialists: If the bunion is severe or surgery is needed (e.g., bunionectomy), the NP can refer the patient to a podiatrist or orthopedic surgeon. They can also coordinate care with physical therapists or other specialists for comprehensive rehabilitation after the injury.
• Patient Education: NPs can educate patients on bunion management, including the use of proper footwear, padding (e.g., moleskin or gel pads) to protect the bunion, and strategies to prevent its worsening. They may also counsel on weight management, as excess weight can increase pressure on the bunion.
• Monitoring Comorbidities: If the patient has conditions such as diabetes or arthritis, which can complicate bunion healing or increase the risk of injury, the NP can manage these conditions to support recovery.

Collaborative Approach

For a personal injury involving or exacerbating a bunion, a chiropractor and an NP can work synergistically:

• The chiropractor addresses biomechanical issues, restores foot function, and provides non-invasive pain relief, which aligns with conservative management.
• The NP handles medical aspects, such as pain control, infection prevention, and referrals for advanced care if the injury or bunion requires it.
• Together, they can create a comprehensive plan that combines manual therapy, exercises, medical interventions, and lifestyle changes to reduce pain, improve mobility, and prevent further damage.

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez is a chiropractic specialist who utilizes her training as a nurse practitioner to assist patients with a range of conditions. Incorporating elements of functional medicine, electroacupuncture, acupuncture, and sports medicine into individualized treatment plans is their specialty. A focus on speed, agility, and flexibility is central to the treatment of injuries and chronic pain disorders at this clinic. Individualized treatment and wellness outcomes are guaranteed for patients of all ages and abilities through comprehensive care plans and virtual and in-person health coaching.

Enhance Your Performance with Functional Foot Orthotics

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