What is a bunion?
A bunion by definition is the protrusion of bone at the base of the great toe. Contrary to popular belief, bunions are inherited, not the result of poor shoe choices. Poor choices in shoes however may exacerbate this problem and cause these bunions to become painful. The first thing that patients usually notice is the reddening of the bony protrusion (Bunion) after wearing shoes, especially tight fitting shoes. Bunions usually occur in both feet although quite often one foot is worse than the other. Bunions can be unsightly and be the source of embarrassment when wearing open shoes. The deformity usually gets worse as one gets older causing progressively more pain and requiring the use of wider shoes to accommodate the “bump” (bunion). There are different severities of bunions which are usually determined by the Podiatrist via the use of x-rays. Your Podiatrist will advise you how severe your bunion is and the proper course of treatment.
What causes a bunion?
Bunion deformity occurs when the long bone just prior to great toe, know as the 1st metatarsal moves inward toward the mid-line of your body. This causes the head of the 1st metatarsal to protrude. The greater the protrusion, the more severe the bunion and therefore the more severe the redness and pain associated with this deformity. What usually follows this movement of the 1st metatarsal bone is the drift of the great toe toward the second toe. In severe deformity, the great toe may over or under lap the second toe. The more severe the bunion, the more likely that the great toe joint will become arthritic and painful. Bunion deformity is often accompanied by hammer toes which will be the subject of future discussion.
How do we treat bunions?
Treatment for this problem usually begins with x-rays. Your Podiatrist will evaluate your x-rays and determine the severity of the deformity. If surgery is eventually chosen, these findings will be important to determine the proper procedure for correction. Initial treatment usually involves anti-inflammatory medication and cortisone injection to reduce swelling and redness of the joint. Conservative care may involve the use of wider shoes to accommodate the deformity. Your Podiatrist will recommend several brands to help your search. Custom molded inserts may also be helpful to resolve any biomechanical imbalances. These devices may slow down the progression of this deformity but will not cure the bunion. If your bunion is advanced, these devices may also require the use of deep shoes with removable insoles. Foot surgery usually involves the removal or cutting of bone. Usually a screw or pin is required to assure proper alignment of the bones. Bunion surgery involves an average healing time of 6-8 weeks.
Call our office if…
- You have pain, redness, or swelling of the great toe joint.
- You have stiffness or poor mobility of the great toe.
- You have difficulty finding shoes to fit due to your bunion.