The many miles we spend on our feet means they can take a beating. The feet do, after all, handle the impact of every step. And sometimes, those landings can lead to pain—particularly if you’re battling bunions.

A bunion is an (often unsightly) protuberance at the base of your big toe. It forms when the metatarsophalangeal joint (MTP for short) is stressed over a prolonged period of time, causing the first metatarsal to turn outward (or medially) and the big toe to point in the opposite direction. The resulting protrusion can cause bunion pain—especially when it starts to chafe in your shoes over the course of long runs.

Some people may also experience a bunion that forms at the base of the pinky toe, as well, known as a bunionette (and sometimes misdiagnosed as a Tailor’s bunion). This pain can sideline you, leaving you looking for bunion pain relief, fast.

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How do you know if you have a bunion?

Bunions are fairly easy to identify. If you have a knobby protrusion at the base of your big or pinky toe, it’s likely a bunion. Your doctor, a podiatrist, or a physical therapist can verify your hunch during an exam. He or she may want to take an X-ray to determine its severity.

In addition to seeing the protrusion, you may get alerted to the formation of a bunion if it starts rubbing against your shoes, causing discomfort and pain.

Bunions can be particularly painful for runners, both because running in the wrong shoes can exacerbate them, but also because they can lead to other foot problems. If you start to unconsciously shift your weight off the painful big toe as you run, you may develop discomfort in the ball of your foot or overcompensate elsewhere, which results in too much impact on the other metatarsals.

The big toe can also dive over or under the other toes, causing corns or hammertoes to develop.

What causes bunions?

There may be a hereditary element to bunions, and having low arches, flat feet, or loose joints can increase your risk of developing them. In some cases, arthritis is to blame.

Lack of strength in the muscles of the foot and wearing narrow, pointed-toe or high-heeled footwear are also causes. This is thought to be one of the reasons women tend to get bunions more than men—they’re more likely to wear tight, high-heeled shoes. But even ill-fitting running shoes can be to blame, says Ray McClanahan, D.P.M., podiatrist at Northwest Foot & Ankle in Portland, Oregon.

Most running shoes have a tapered toe box (that is, they get narrower at the toe) as well as a slightly elevated heel (known as drop—the height difference between the heel and forefoot often measured in millimeters). Wearing a running shoe with a significant drop year after year can be a recipe for bunions, says McClanahan, who is a long-distance runner.

McClanahan often references what our feet looked like when we were babies: Our toes are splayed out wider than the rest of our foot. Interestingly, shoes for babies are still designed to accommodate this natural foot shape, which aids a child’s balance when learning to walk. “But at two years old, we literally start making miniature versions of adults’ shoes,” he says. “We start deforming our toes.”

Indeed, in shoeless societies, deformities like bunions, hammertoes, and plantar fasciitis, are so rare as to be non-existent. (Dr. William A. Rossi’s seminal article called “Why Shoes Make Normal Gait Impossible,” argues this and he lays out how, in industrialized societies, foot deformities are directly caused by faulty footwear.)

faster running as high heels, take a closer look. Most running shoes have a 2:1 heel-to-forefoot ratio, which can help tip us forward for Though you probably wouldn’t classify your faster running. But over time, it can also shorten your Achilles tendon, which in turn weakens and flattens your arch. This—coupled with a tapering toe box that squashes your big toe into the space that should be occupied by the second toe—can create (you guessed it!) a bunion.

How can you get bunion pain relief?

Treatment for bunions starts with changing your shoes. High heels are definitely a no-no, as they tip the body’s weight forward, forcing your toes into the front of the shoes.

Applying ice to your bunion and/or using acetaminophen, ibuprofen, or even cortisone injections can help control the pain in the short term. Using moleskin, gel-filled pads, or shoe inserts for arch support may also help.

Can bunions go away?

If these conservative treatments don’t provide relief, the next step is to see a professional. When the bunion starts causing pain that impacts activities of your daily life, like walking or running, many conventional podiatrists will recommend surgery as a next step.

There are many types of bunion surgeries, but in most cases, the operation involves shaving back the big toe and severing the “adductor hallucis” muscle between your big toe and the next toe. Full recovery can take several months to a year, depending on the exact procedure, according to the American Academy of Orthopaedic Surgeons (AAOS).

According to the American Podiatric Medical Association (APMA), a bunionectomy, which removes the bony prominence, is used for the less severe deformity. If a bunion is more severe, a surgery which involves cutting the bone and realigning the joint may be necessary. According to John’s Hopkins Medicine, recovery times will vary and you may need to wear a brace or dressing for six to eight weeks.

During the 15 years he spent as a podiatrist, McClanahan performed hundreds of bunionectomies. What he saw is that surgery is not a permanent solution. “If a runner had surgery and went back to running in the same type of running shoe they had before the surgery, their bunion would come back,” he says. That’s because their big toes were still being held in a partially dislocated position.

At his Portland practice, McClanahan has a three-pronged regimen for reversing bunions. Hundreds of his patients with bunions have seen results with these natural methods.


3 Ways to Get Bunion Pain Relief Without Surgery

1. Wear a toe spacer

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            McClanahan’s branded version is called “Correct Toes,” but you’ll find many options out there. Think of toe spacers as braces for your toes—it helps train your toe bones to get back into their natural alignment. Another brand is called YogaToes, which spaces the toes, but are less slim so they’re best worn barefoot. Or you can try the brand Naboso, which even comes with a carrying case and can also fit under socks.

            McClanahan has patients with bunions wear the toe spacers around the house for just 30 minutes a day at first. (Don’t get overzealous. Some patients, thinking more is better, have worn them to bed and wake up with debilitating leg cramps.) Eventually, you can wear them in your shoes and even while running. (Keep in mind, YogaToes are bigger so they work best when lounging or during a yoga practice.)

            2. Try wider running shoes

            McClanahan also recommends wearing running shoes that are wider at the end of the toes than at the ball of the foot and that do not have an elevated heel—what is known as “zero drop.”

            In the running shoe category, Altra, Topo, Lems, and Vivobarefoot top the list of options. McClanahan recommends starting with a more supportive shoe like Altra or Topo—both of which are seen as “transition shoes” to more minimalist running shoes—and working your way down to more minimal shoe. (Transitioning to any shoe too quickly can cause injuries—but especially a minimalist shoe so practice caution.)

            Maggie Fournier, D.P.M., president of the American Academy of Podiatric Sports Medicine, is on board with the wide-toed running shoes, but she’s less enthusiastic about zero drop shoes. “You have to be careful. It can trigger other issues,” she says.

            For this reason, McClanahan recommends slinging your new pair around your shoulder (or carrying them in a small backpack), running for a few miles in your old shoes and then doing just 1/4 to 1/2 a mile in the new pair, gradually working up to the full length of your run.

            3. Do a bunion massage

            A bunion massage stretches the adductor hallucis. “You take the toe out and you get inside there. People with a bunion will have a trigger point, where the muscle got short,” he says. Once you find it, rub there. Do this as often as possible. While anecdotal evidence, one 59-year-old patient did this for hours a day while watching soap operas and, according to McClanahan, saw a “remarkable decrease” in her bunion in nine months. (See the detailed instructional video on his site.)


            How can you prevent bunions in the first place?

            You can prevent bunions by wearing comfortable, wide-toed shoes and avoiding narrow, tight, high-heeled shoes. Wearing toe spacers and massaging the adductor hallucis may help, too, though there is no definitive research showing that either prevent bunions.

            However, one systematic review and meta-analysis published last year in the International Journal of Environmental Research and Public Health did find that a combination of exercise, toe separators, night splints, and dry needling were good options for reducing bunions. It also said toe separators, along with dry needling and manipulation, also improved patients subjective feelings about their bunions.

            Fournier at the AAPSM has this to say about toe spacers: “The worst it’s going to do is nothing. You might as well use them for 30 minutes a day.”

            There are added benefits to this regime, too. Since most of the muscles of the feet and lower legs insert into the last toe bone (the distal phalanx), when people start wearing toe spacers, other parts of the body improve, too. “People come back and they think we were just working on their feet, and they say, ‘Jeez. My core engaged’ or ‘My cervical spine feels better.’” That’s the amazing part of the kinetic chain—it’s all connected.

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