Best Bunion Exercises and Nonsurgical Treatment

Many women have a bunion — a deformity of the metatarsophalangeal (MTP) joint at the base of the big toe. A bunion develops when the first metatarsal bone of the foot turns outward and the big toe points inward (toward the other toes), causing the joint to jut out (see “Anatomy of a bunion”). The Latin name for the deformity is hallux valgus (hallux means big toe, and valgus means turned away from the midline of the body). Most shoes don’t accommodate the resulting protrusion and so put pressure on the misaligned joint. Eventually, the bursa (a fluid-filled sac that surrounds and cushions the joint) becomes inflamed, and the entire joint becomes stiff and painful.A bunion is most likely to develop when susceptible feet are repeatedly squeezed into narrow, pointed-toe footwear. The big toe pushes against the other toes, sometimes diving over or under them. As a result, the base of the big toe — the metatarsophalangeal (MTP) joint — juts or angles out from the foot. To judge how severe a bunion is, clinicians take an x-ray and measure angles between certain bones in the foot, in particular, the hallux valgus angle (HVA) — the angle between the first metatarsal and the big toe — and the angle formed by the first and second metatarsals, called the intermetatarsal angle (IMA). The upper limit of normal for the HVA is 15 degrees; for the IMA, 9 degrees.The first step is to relieve the pressure by wearing the right kind of shoe. (It’s also important to maintain a normal weight.) Shoes should have a wide, flexible sole to support the foot and enough room in the toe box (the part surrounding the front of the foot) to accommodate the bunion. Some good choices are sandals, athletic shoes, and shoes made from soft leather. Shoes with a back should have a sturdy heel counter (the part surrounding the heel) to keep the heel of the foot snugly in place. You may be able to reshape narrow shoes with stretchers that make room in the toe box for the bunion. Keep heels low (no higher than an inch).
You can also protect the bunion with a moleskin or gel-filled pad, available at drugstores. (Make sure your shoes have enough space to accommodate it.) A clinician may recommend semisoft orthoses (shoe inserts) to help position the foot correctly as it strikes the ground. You can also wear a splint at night to hold the toe straight and ease discomfort.
When the bunion is irritated and painful, warm soaks, ice packs, and nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help. Whirlpool, ultrasound, and massage may also provide some relief. Cortisone injections can relieve pain temporarily by reducing inflammation, but they have many side effects, especially when used often and at high doses.
https://www.health.harvard.edu/diseases-and-conditions/what-to-do-about-bunions

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