I am 62 years old and have had a bunion on my big toe for years, but lately it has become more painful and more difficult to find comfortable shoes. I would like to avoid surgery if possible. What can I do to ease the discomfort and keep it from getting worse?

Bunions are very common and often become more painful with age as the joint shifts out of alignment and inflammation occurs. What may have started as a minor nuisance can turn into ongoing discomfort, making it difficult to find shoes that fit comfortably.

A bunion, known medically as hallux valgus, is a bony bump that forms at the base of the big toe when the joint moves out of place. This causes the toe to angle inward while pushing the joint outward, which creates a noticeable bump.

Why it happens

While tight or narrow shoes can make bunions worse, they are usually not the root cause. Genetics plays a major role, which is why bunions often run in families. Other factors like flat feet, arthritis and past foot injuries can also contribute. Women tend to be more prone to developing bunions, partly due to years of wearing high heels or shoes with narrow toe boxes. The good news is that most bunions can be managed without surgery, especially if your goal is to ease symptoms and slow their progression.

Simple relief

The first place to start is with the right shoes. Switching to footwear with a wide toe box, soft materials and good arch support can make a big difference. High heels and tight shoes that crowd your toes should be avoided. It can also help to shop later in the day, as your feet naturally expand throughout the day.

Beyond footwear, a few simple steps can help ease the pressure. Padding the area with over-the-counter bunion cushions can help reduce friction. If the joint becomes sore or swollen, icing it for 10 to 15 minutes a few times a day may bring relief. Anti-inflammatory medications, both prescription and over-the-counter, may also help if your doctor determines they are appropriate for you.

To further reduce strain, orthotic inserts may improve how your foot distributes weight. Inserts may be either store bought or custom made. Toe spacers may also help by keeping the toes in a more natural position. A night splint can gently guide the big toe into better alignment while you sleep.

It may also help to rotate your shoes rather than wearing the same pair every day, reducing repeated pressure. In addition, gentle exercises can help maintain flexibility such as stretching your toes, picking up small objects with your foot or rolling your foot over a tennis ball. It is important to keep expectations realistic, as these steps will not eliminate a bunion, but they can make it more manageable.

When to get help

If your bunion pain interferes with daily activities or if you are developing corns, calluses or ongoing inflammation, it is wise to see a podiatrist or orthopedic specialist. They can evaluate the severity and recommend additional treatments. You should also seek care if you notice redness, warmth or significant swelling, which could signal irritation or infection around the joint.

Surgery is typically advised only when conservative measures no longer provide relief. Today’s procedures are more advanced than in the past and are often done on an outpatient basis, though recovery can last about six to 12 weeks and bunions can sometimes recur.

In the meantime, taking steps to protect your feet can go a long way. With the right care, many individuals can manage bunions effectively and move comfortably.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.