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Bunions

What is a Bunion?

BunionBunions are a common problem that most people experience as a bony protuberance at the base of the big toe. A bunion, however, is more complicated than simply a bump on the foot.

When a patient has a bunion, the big toe angles in towards the other toes, a condition called hallux valgus. Bunions are most common in women. The skin over your big toe may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. If this condition gets severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis. Bunions tend to get progressively worse over time without treatment.

Causes and Risk Factors of Bunions

Bunions are most often caused by an inherited faulty mechanical structure of the foot. This faulty structure causes the drifting of the great toe and the bone to become prominent on the side of the foot. The skin then gets pinches by this bony prominence and the shoe. Therefore in most cases bunions are not caused by tight shoes but are made more painful by tight shoes. End stage bunions may become painful both in and out of shoes.

Symptoms of Bunions

  • Pain or soreness
  • Inflamattion and redness
  • A burning sensation
  • numbness on the side of the great toe

Other conditions which may occur secondary to bunions include calluses on the big toe, sore between the toes, ingrown toenails, and stiffness of the joint where the great toe attaches to the foot.

Treatment of Bunions

Somtimes observation of the bunion is all that’s needed. A periodic exam and x-ray can determine if your bunion deformity is advancing. Measures can then be taken to reduce the possibility of permanent damage to your joint. In many cases, however, some type of treatment is needed. Conservative treatments may help reduce the pain of a bunion. These options include:
  • Changes in shoewear
    Wearing the right kind of shoes is very important. Choose shoes with a large toe box and avoid narrow high heeled shoes which may aggravate the condition.
  • Padding
    Pads can be placed over the area to reduce shoe pressure.
  • Medication. Nonsteroidal anti-inflammatory drugs may help reduce inflammation and reduce pain.
  • Injection therapy
    Injection of steroid medication may be used to treat inflammation that causes pain and swelling especially if a fluid filled sac has developed about the joint.
  • Orthotic shoe inserts
    By controlling the faulty mechanical forces the foot may be stabilized so that the bunion becomes asymptomatic.

Who are candidates for Bunion Surgery?

Anyone who experiences symptoms from bunions should see a podiatrist for treatment. But you may benefit from surgery if you have any of the following:

  • Severe foot pain that limits your everyday activities, including walking and wearing comfortable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain.
  • Chronic big toe inflammation and swelling that doesn’t improve with rest or medications.
  • Toe deformity – a drifting of your big toe toward the small toes.
  • Toe stiffness – inability to bend and straighten your toes.
  • Failure to obtain pain relief from anti-inflammatory drugs.
  • Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medications.

What is the Bunion Surgery recovery process?

Recent advances in surgical techniques have led to very high success rates for bunion surgery. In most cases the patient can walk immediately after surgery without crutches. As well most patients find the surgery to be virtually pain free. Almost all bunion surgery is done as an outpatient at a surgery center. Most bunion surgery is performed with a local anesthetic block and IV sedation (twilight sleep). After the procedure you will be moved to the recovery room for about an hour. You will then be ready to go home.