A bunion (also known as hallux valgus) is a bony projection or bump that forms at the base of the big toe. If the joint at the base of the big toe is subjected to great pressure while walking, the big toe can gradually turn inward towards the second toe. The big toe then bears weight at an unusual angle. This causes the joint to deteriorate and a bulge to appear on the side (medial part) of the foot and can become painful.
People with Down syndrome
Many (but not all) people with Down syndrome develop bunions, probably because of joint laxity (joints that are very flexible) and flat feet. As is the case with many other painful conditions, people with Down syndrome often do not complain of pain with bunions. If a person with Down syndrome is not complaining of pain or demonstrating pain, then the main indicator that a bunion needs to be addressed might be a change in the person’s ability to walk or participate in activities.
Treatment
Surgery is the definitive treatment for bunions but there are several things that can be done to try to relieve pain and delay or avoid surgery. These include:
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Wearing shoes that fit properly, are wide in the toe, and have a low heel.
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Avoiding high heels (because they put increased stress on the joint).
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Icing the feet or soaking the feet in warm water to reduce inflammation and pain.
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Using anti-inflammatory medications (e.g., Motrin) or acetaminophen (e.g., Tylenol).
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Using pads or inserts to reduce or relieve discomfort at pressure points.
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Wearing a bunion splint to relieve pressure and pain. While bunion splint manufacturers may suggest that the splints realign the big toe, there is no evidence that splints can “correct” the bunion. However, some people experience pain relief from the splints.
The American Podiatric Medical Association (APMA) website provides a list of products that have been given the APMA Seal of Acceptance and Seal of Approval. These products have been reviewed by group of APMA podiatrists and found to promote good foot health. More information can be found on the APMA website .png "opens in new window")
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If symptoms persist despite these measures, we recommend seeing a podiatrist or orthopedic surgeon who provides foot care. Surgery may be recommended. There are different surgical options for bunions and many factors influence which option is selected. We recommend consulting with your doctor to determine which procedure is appropriate for your situation.
Recurrence
Sometimes bunions recur after surgery. In our experience, this seems to occur more often in people with Down syndrome, possibly because of joint laxity. Because of this possibility of recurrence, we recommend beginning with the conservative therapies described above. If these measures are inadequate and there are significant symptoms or loss of function, the benefits of surgery may outweigh the challenges and discomfort of surgery.
Additional Resources
Flat Feet in People with Down Syndrome
Overpronation in People with Down Syndrome