Bunions
Even though bunions are a common foot deformity, there is a lot of confusion about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.
What is a Bunion?
A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment - producing the bunion's "bump."
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.
Causes
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.
Although wearing shoes that crowd the toes won't actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.
Symptoms
Symptoms, which occur at the site of the bunion, can include:
- Pain or soreness
- Inflammation and redness
- A burning sensation
- Difficulty wearing shoes comfortably
- Numbness in the big toe
Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can also aggravate bunions.
Diagnosis
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon will take x-rays to determine the degree of the deformity and assess the changes that have occurred.
Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non-Surgical Treatment
Sometimes observation of the bunion is all that's needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised.
In many other cases, treatment is needed. Early treatments are aimed at easing the pain of bunions, but they won't reverse the deformity itself. These include:
- Orthotic devices - Orthotics won't make a bunion go away, but they can slow or stop it from getting worse.
- Injection therapy - An inflamed bursa (bursitis) commonly develops over a bunion. A cortisone injection can reduce the pain and swelling of bursitis.
- Changes in shoewear - Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition.
- Padding - Pads placed over the area of the bunion can help minimize pain. These can be obtained from your surgeon or purchased at a drug store.
- Medications Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
When Is Surgery Needed?
If non-surgical treatments fail to relieve bunion pain, and when the pain of a bunion interferes with daily activities, it's time to consider bunion surgery.
A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the "bump" of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that have occurred. The goal of surgery is the reduction of pain.
In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures.
Common Questions:
How much pain is associated with corrective Bunion surgery?
Thanks to state of the art methods of surgery and better medications, most patients relate that the post operative pain is much less than they anticipated.
How long will I be off work?
This varies depending on the type of procedure needed to correct your bunion, and the type of work you do. Some patients are only off work a few days and others do better recovering at home the first several weeks following surgery.
Can the Bunion return?
It is unlikely. The techniques utilized by the doctors of the North Shore Podiatry Group have a long-term success rate that exceeds 90%. Your doctor will evaluate your foot structure and x-rays and recommend the procedure that has the best chance of sustained correction of the Bunion.
I'm worried about my child who seems to have an early Bunion deformity. Can anything be done?
The doctors of the North Shore Podiatry Group treat children as young as age 2 with early bunion deformity. We may recommend padding and splinting the toe. Often, custom orthotics can slow or stop progression of a bunion. Sometimes, we monitor the condition until growth is complete or the bunion becomes painful. At that time, surgery can be scheduled.