Bunions
What is a Bunion?
What Causes a Bunion?
Symptoms
Diagnosis
Treatment
When is Surgery Needed?
Frequently Asked Questions (FAQs) about Bunion Surgery
Print this page: What to ask Your
Foot and Ankle Surgeon about Bunion Surgery
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 (hallux valgus) 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 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 foot and ankle 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 foot and ankle 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 foot and ankle surgeon.
When is Surgery Needed?
When the pain of a
bunion interferes with daily activities, it's time to discuss surgical options
with your foot and ankle 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 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.