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 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 leads to the prominence that we call a bunion. Fun fact, bunions share the same name as turnip in Greek and who likes turnips anyway? Usually, the symptoms of bunions appear at later stages, although some people never have symptoms.
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 cause bunions in the first place, these shoe types are not helpful. Tight shoe gear can accelerate bunion symptoms. I recommend wider shoes when bunions are present. It’s funny, patients don’t measure their feet after the 11th grade. I recommend periodic measurements of your feet at a shoe store to accurately know your shoe size. Changes happen, and events such as pregnancy or weight change can change your foot size.
The 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. It is also noted that summer is a relief for patients as they move to flip flops rather than closed shoes.
Symptoms, which occur at the site of the bunion, may include pain, soreness, inflammation, redness and perhaps numbness. Other conditions which may appear with bunions include calluses on the big toe, sores between the toes, ingrown toenail and restricted toe motion.
Bunions are obvious—you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, a doctor may take X-rays to determine the degree of the deformity.
Because bunions are progressive, they don’t disappear and will usually worsen over time. But not all cases are alike—some bunions progress more rapidly than others. Once a doctor has evaluated your case, a treatment plan can be developed that is suited to your needs.
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 shoe gear. 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 at my office.
• 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.
• Orthotic devices. In some cases, custom orthotic devices may be provided by a doctor.
When the pain of a bunion interferes with daily activities, it’s time to discuss surgical options. We 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 case, a doctor 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.
David Weiss, DPM, is the owner of Weiss Foot & Ankle Center located at 777 South White Horse Pike, Suite D1 in Hammonton. For more information or to make an appointment, call 561-2488 or visit weissfootandankle.com.