If you’re young and active, you probably don’t think much about bunions, the sometimes painful bumps that develop in the joint at the base of your big toe. But according to a recent study, one-third of people over the age of 65 have one. While they’re fairly common later in life, you can take a few precautions now to avoid them.

What's a Bunion?

A bunion usually forms when you walk incorrectly and your big toe joint sustains years of abnormal motion and pressure. Your bone at that joint moves towards your other foot, and the big toe then bends towards the little toe, causing a bony lump on the foot joint.

“Because that particular joint carries a lot of the body’s weight, bunions can cause instability and extreme pain,” says Michael DiGiacomo, DPM, a podiatrist at Alta Bates Summit Medical Center in Oakland. Bunions can also make some shoes difficult, if not impossible, to wear.

Prevent a Bunion

The shoes you wear, the work you do and your inherited foot type all influence bunion development.

Walking in shoes that are too tight or that angle your big toe into your other toes, like women’s pumps, can cause bunions. That’s why the condition tends to be more common in women. To reduce your risk, avoid high heels and narrow shoes.

You’re also more prone to bunions if you have a job that puts a lot of stress on your feet. Bunions are an occupational hazard for many ballet dancers, for instance.

People with flat feet or low arches are more likely to develop the condition, and since foot type is inherited, bunions often run in families. If you have flat or overpronated feet, wear good shoes and inserts that support your arch.

Foot injuries, inflammatory joint disease and neuromuscular disorders also lead to bunions.

Self-Care and Surgery

You usually don’t need to treat bunions unless they’re painful. If you have one, start with self-care. Wear wider shoes, use inserts for arch support and place gel padding around your bunion. If your bunion becomes painful or inflamed, ice it several times a day to reduce swelling.

If your pain worsens or walking becomes unstable, talk to your podiatrist. Initially he or she may recommend conservative treatments:

• Pad your bunion and tape your foot to keep it in a normal position.
• Consider anti-inflammatory drugs and cortisone injections to minimize inflammation.
• Explore physical therapy.
• Use orthotics to control the abnormal motion in your feet.

Bunions can also affect your second toe. If you notice that it’s starting to bend and buckle, see your podiatrist immediately. “If you don’t treat it, your second toe could come out of its socket,” says Dr. DiGiacomo. “Then the bunion gets harder to correct and causes more deformity.” The deformity could also affect your balance because you can’t effectively use your first and second toes to push off the ground.   

If your bunion grows more severe, your podiatrist might suggest one of the following surgeries:

• Bunionectomy – Doctors remove part of the bone causing the bunion and reposition it to restore alignment of your big toe joint.
• Joint Replacement Surgery – If your joint is damaged beyond repair, doctors can replace it with an artificial joint.
• Fusion Surgery – In severe cases, doctors might fuse the joint associated with your bunion so that it won’t move. The caveat is that after fusion surgery, you may not be as athletically active as you were before.

“If you have a bunion, care for it right away,” says Dr. DiGiacomo. “The longer a bunion persists, the more likely you’ll need surgery.”