How To Make Bunions and Hammertoes a Less Painful Experience

If you’ve sprouted a big bump on the inside of your foot just below your big toe, it’s likely that your parents, grandparents, aunts or uncles had one, too. It’s called a bunion, and they’re largely hereditary. When the metatarsal — the long bone in our feet — starts deviating outward, the big toe shifts inward, causing the bump. But while genetics plays the biggest role, factors that can make bunions harder or easier to live with are in your control.

Hammer Time

The second most-common cause of bunions is poorly fitting shoes. Those cute little flats that were half a size too small that you just had to have? They may well be making your situation worse, and harder to correct. Another less-common reason for bunions: injury. Ever sprained or broken your big toe as a kid? That can give you a predisposition to bunions later in life.

Bunions often are accompanied by what’s called a hammertoe, where the big toe pushes against the smaller toes, forcing them to cock upward like a hammer, with large knots developing at the knuckle of the smaller toes.

Bunions can incline you to getting a hammertoe, but you also can have hammertoes without a bunion — people with high arches are more likely to have hammertoes because the tendons on top of their feet pull harder, sending the toes upward and causing them to stay that way. Injuries left untreated or that heal in the wrong position also can cause hammertoes, as well as habitually wearing shoes that are too small.

Conversely, wearing shoes that are too big allows your foot to slide around, causing you to grip the shoes with your toes to hold your foot in place. That chronic gripping also can lead to hammertoes.

Don’t Delay

Bunions and hammertoes usually are progressive, growing and changing slowly. That means most people don't seek treatment until it’s painful and preventing them from wearing the shoes they prefer or doing activities they love. If you don’t seek medical advice until late in the process, treatment options are limited.

The only way to truly fix the problem is surgery. Doctors must break the toe bones, shift everything back into place and then install hardware like a screw, pin or plate to hold the bones in place so they don't shift back.

Unfortunately, bunions and hammertoes frequently recur after surgery. There are 26 bones in your foot, and when you start manipulating any of them you are going to affect the others as well — there’s a limit to how much surgeons can mess with your overall architecture. Rheumatoid arthritis also can cause bunions to recur, if it causes changes in the feet and joints.

Another reason to seek prompt medical advice: Conditions like gout or a cyst can mimic a bunion, so it’s good to get baseline X-rays as soon as you notice a change, so you know what you are dealing with.

The Natural Option

Another way to treat bunions and hammertoes is simply to accommodate them with a wider shoe, one with a taller, wider toe box. There also are bunion splints you can buy that use wrap-around straps to try to realign the big toe. Neither of those approaches will fix or reverse the bunion or hammertoe; they just help to stabilize them as they are. Even accommodation isn’t an easy fix for severe cases — with very open shoes like flip-flops or sandals, straps still can rub across the altered toes and cause blisters.

Not everyone can go barefoot — people with neuropathy or nerve problems sometimes can't walk on a hard surface without padding or cushioning — but for those who can, going barefoot eliminates the deforming forces of shoes and helps strengthen our muscles. When we wear shoes every day, the layers of muscles in our feet don't work as hard and eventually become dependent on the shoes. By going barefoot, you strengthen the muscles in your feet, helping to avoid bunions and hammertoes.