What is a Bunion?
A bunion occurs when the big toe angles towards the second toe. This makes a painful prominence along the inside of the foot, known as a bunion.
The prominence can rub on the inside of the shoe making walking and exercise very difficult.
In severe cases, the bunion can affect the lesser toes as well, causing further pain and deformity.
What Causes Bunions?
• Bunions can be caused by:
• Poor shoe wear
• Inherited risk
• Severe flat feet
• Rheumatoid arthritis
• Loose ligaments
Bunions occur most commonly in women who wear fashionable shoes with a narrow toe box and high heels. These types of shoes force the toes into a narrow wedge shape. Over time this can result in the big toe moving laterally.
Not all women who wear heels get bunions, and men can suffer from bunions as well. There may also be a hereditary component to the development of bunions. Patients with “inherited” bunions often have abnormally shaped bones or joints that put them at risk.
What are the Symptoms of a Bunion?
• Redness, skin irritation over bunion from rubbing
• Pain with shoe wear
• Less painful when barefoot or with comfortable shoes
• Severe bunions may result in secondary pain and calluses under the ball of the foot
• Cosmetic deformity
• Limited shoe wear
How are Bunions Diagnosed?
Bunions are diagnosed on physical exam by the foot and ankle specialist. The exam focuses on how severe the deformity is and if the big toe joint is flexible or stiff.
The physician will also look for other areas of pain or deformity in the foot associated with the bunion. X-rays with the patient standing are necessary to accurately assess the degree of angulation of the big toe joint and to plan for possible surgery.
Conservative Treatment for Bunions
Conservative treatment is directed at protecting the bunion from pressure or friction caused by shoe wear. The simplest solution is to wear properly fitted shoes that are wide enough to accommodate the forefoot.
Shoe repair stores can often stretch the material over the bunion to prevent rubbing. Other strategies attempt to cushion or offload the bunion and can include:
• Shoe wear modification
• Bunion pads
• Toe spacers
• Non-steroidal anti-inflammatory medications
Surgical Treatment for Bunions
The goals of surgery are to relieve pain. Patients who do not have pain should not consider surgery. Surgery should only be performed after all conservative measures have failed.
Mercy surgeons offer many different types of bunion surgery including a minimally invasive bunion surgery option that is not widely available at other institutions.
It is critical that the foot and ankle specialist carefully evaluate your foot to determine which surgery is best for your specific deformity in order to avoid recurrence.
Bunion surgery includes:
• Removing the bony prominence on the side of the foot (bunionectomy)
• Cutting or fusing the 1st metatarsal bone to re-align it and make the forefoot more narrow
• Cutting the big toe bone (phalanx) to straighten the toe
• Tightening ligaments that have become stretched out