Bunions
Even though bunions are a common foot
deformity, there are misconceptions about
them. Many people may unnecessarily
suffer the pain of bunions for years before
seeking treatment.
What is a Bunion?
Bunions are 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.
With a bunion, 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
continues to become increasingly prominent. Usually the
symptoms of bunions appear at later stages, although some
people never have symptoms.
What Causes a Bunion?
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 in the first place, it sometimes makes the
deformity get progressively worse. That means you may
experience symptoms sooner.
Symptoms
Symptoms occur most often when wearing shoes that crowd
the toes—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 aggravate the symptoms of bunions.
Symptoms, which occur at the site of the bunion, may include:
• Pain or soreness
• Inflammation and redness
• A burning sensation
• Perhaps some numbness
Other conditions which may appear with bunions include
calluses on the big toe, sores between the toes, ingrown toenail
and restricted motion of the toe.
Diagnosis
Bunions are readily apparent—you can see the prominence
at the base of the big toe or side of the foot. However, to fully
evaluate your condition, the podiatric foot and ankle surgeon
may 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 podiatric
surgeon has evaluated your particular case, a treatment plan
can be developed that is suited to your needs.
Treatment
Sometimes observation of the bunion is all that’s needed. A
periodic office evaluation and x-ray examination can determine
if your bunion deformity is advancing, thereby reducing your
chance of irreversible damage to the joint. In many other cases,
however, some type of treatment is needed.
Early treatments are aimed at easing the pain of bunions, but
they won’t reverse the deformity itself. These options include:
Changes in Shoewear Wearing the right kind of shoes is very important. 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.
You can get bunion pads from your podiatric surgeon or
purchase them at a drug store.
Activity Modifications Avoid activity that causes bunion pain, including standing
for long periods of time.
medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such
as ibuprofen, may help to relieve pain.
Icing Applying an ice pack several times a day helps reduce
inflammation and pain.
Injection Therapy Although rarely used in bunion treatment, injections of
corticosteroids may be useful in treating the inflamed bursa
(fluid-filled sac located in a joint) sometimes seen with bunions.
orthotic devices
In some cases, custom orthotic devices may be provided
by the podiatric surgeon.
Orthotic Devices In some cases, custom orthotic devices may be provided
by the podiatric surgeon.
When is Surgery Needed?
When the pain of a bunion interferes with daily activities, it’s
time to discuss surgical options with your podiatric surgeon.
Together you can decide if surgery is best for you.
Recent advances in surgical techniques have led to a very high
success rate in treating bunions.
A variety of surgical procedures are performed to treat bunions. The procedures are designed to remove the “bump” of bone,
correct the changes in the bony structure of the foot, as well as
correct soft tissue changes that may also have occurred. The goal
of these corrections is the elimination of pain.
In selecting the procedure or combination of procedures
for your particular case, the podiatric 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 performed.
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