A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. As time goes on the big toe starts to drift toward the smaller toes, making the bunion deformity worse.
Pain from bunions develops over the bump due to shoe irritation, and in the other toes due to crowding and altered biomechanics at the forefoot. Often, this deformity worsens over time and makes it painful to wear shoes or walk.
Bunions may be caused by wearing poorly fitting shoes, in particular shoes that are narrow, high-heeled or pointed, keeping feet in an unwanted position. Some bunions can also be hereditary and form earlier in life. People who have inflammatory conditions such as rheumatoid arthritis are also prone to them. Bunions are more common in women than men.
Once you go to the doctor a full history and physical exam will be taken. Likely x-rays will be taken to check the alignment of your toes and look for damage to the joint, they will look at whether there is arthritis associated with the bunion, and to see how severe the bunion is, and how best to correct it. In most cases, bunion pain can be treated conservatively.
Conservative Treatment:
- Change in shoe wear, purchase shoes with a wider toe box
- Padding/cushioning to the shoe to help with the rubbing against the shoe.
- Orthotics help stabilize the arch and forefoot to prevent further breakdown/ worsening of bunion
- Splints/ braces can temporarily relieve pain but rarely solve the problem
- Anti-inflammatories
- Joint injections if there is associated inflammation/arthritis
Your doctor may recommend surgery for a bunion if, after trying conservative therapy you continue to have pain and difficulty walking. The goal of bunion surgery is to relieve pain by realigning the bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position. Bunion surgery should not be considered for solely cosmetic purposes.
There are many surgical options to correct bunions.Your doctor will recommend a type of bunion surgery for you based on your X-rays and physical exam findings. Surgery can be done open or minimally invasive as well.
Bunion surgery is typically performed as a same-day procedure with no hospital stay. Depending on which type of bunion surgery you have, you may be able to weight bear in a surgical shoe right after surgery or may be in a splint/ protective weight bearing after the surgery.
Here at Brucato Foot and Ankle we take x-rays, fit you for orthotics custom orthotics and provide other conservative options. All of our doctors are trained in both open and minimally invasive bunion surgery.
