Podiatry Factoid

The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.

About Bunions and Bunion Surgery

What is a bunion?

A bunion is an enlargement of the joint at the base of the big toe; the metatarsophalangeal or MTP joint that forms when the bone or tissue at the big toe joint moves out of place. This enlargement can also be often described as a big bump and also known as hallux valgus. But a bunion is more than a bump or enlargement of a joint. The visible bump actually reflects changes in the bony framework of the front part of the toe. Since this joint carries a lot of the body?s weight while walking, bunions can cause much pain if left untreated. At this point the bump or enlargement forces the toe to lean towards the second toe, rather than pointing straight ahead; throwing the bones out of alignment thus producing the bunion or bump.

The MTP joint itself can become stiff and sore, making event the wearing of shoes impossible or difficult to say the least. Bunions are a progressive disorder. They begin with the leaning of the big toe gradually changing the angle and direction of the bones over years and slowly producing the enlargement or bump.

The word bunion is from the Latin word "bunio", meaning enlargement ? can also occur on the outside of the foot along the little toe, and then would be called a "bunionette" or "tailor?s bunion".

What causes a bunion?

This is a very common question and below are four common reasons.

Bunions can form when the normal balance of forces exerted on the joints and tendons of the foot becomes disrupted. This can lead to instability in the joint and cause the deformity. Brought about by years of abnormal motion and pressure over the MTP joint.

Bunions can also be caused by and are most often are the result of an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but the certain foot types or poor foot mechanics that make a person prone to developing a bunion from imbalance pressure being exerted on and within the foot.

Although wearing shoes that crowd the toes won?t actually cause bunions in the first place, it can make this deformity get progressively worst. You can experience symptoms of the bunion sooner.

Other causes of bunions are congenital deformities, foot injuries, or neuromuscular disorders. Those who suffer from low arches, flat feet can also be prone to developing bunions as are arthritic patients and people with inflammatory joint diseases. Another factor is one?s occupation which can place undue stress on the foot such as ballet dancers, for example.

Symptoms

Shoes that have a tight toe box or high heels can produce bunion symptoms. This may explain why women suffer from bunions more so than men. If you spend a lot of time on your feet for long periods of time can aggravate the symptoms of bunions.

Symptoms which occur at the site of a bunion can include the following:

  1. The development of a firm bump on the outside edge of the foot, or base of the big toe.
  2. Pain, soreness, redness, swelling, inflammation, a burning sensation or numbness.
  3. Possible corns or other irritations, such as an ingrown toenail caused by the overlapping of the first and second toes.
  4. Restricted or painful motion of the big toe.

Diagnosis

Readily apparent, bunions are prominent at the base of the big toe or side of the foot. But for a podiatric surgeon to fully evaluate your condition, one of our doctors will take x-rays to determine the severity of the deformity and assess appropriate changes and recommendations for your individual treatment plan.

Treatment

Treatment options vary with the type and severity of each case. However, identifying the deformity early on in its development is important in possibly avoiding surgery and engaging in a treatment plan that is less evasive. With the first indication of pain, you should seek podiatric medical attention because left untreated your condition can become worst making non-surgical treatment less of an option.

Early treatments are aimed at easing the pain of bunions, however they won?t reverse the deformity itself.

Here are some treatment recommendations:

  1. Change your shoe gear. Here is where the right shoe can help; wearing one with a wide shoe box and less of a high heel will help forgo the pain felt with other types of shoe gear.
  2. Padding and Taping. This often the first step in treatment, padding minimizes the bunion pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain.
  3. Medication. Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation.
  4. Physical Therapy. This therapy is used to provide relief from inflammation and bunion pain. Ultrasound, electric stimulation, whirlpool baths and ankle/foot wraps are a popular technique for treating bunions and their associated soft tissue involvement.
  5. Orthotics. In some cases, custom orthotic devices may be provided by us to help reduce symptoms and prevent further development of the bunion.
  6. Injection therapy. Although not used too much but in some cases an affective option, injections of corticosteroids may be useful in the treatment of pain and inflammation. The injection is injected into the fluid-filled sac located in the joint.

When is Surgery Needed?

When early treatments are unresponsive or the pain of the bunion interferes with daily activities, it may be time to discuss with one of our podiatric surgeons about surgical options. Together we can decide if surgery is best for your situation to relieve the pain and pressure and repair the toe joint.

Recent advances in surgical techniques have led to a high success rate in the treatment of bunions. Dr. Iannello uses a plastic surgical incision to leave minimal scarring.

The surgical procedures are design to remove the "bump" of bone, correct the changes in the bony structure of the foot, as well as correct soft tissue changes that also may have occurred. Remember the purpose or goal of bunion correction is to eliminate the pain. Each patient condition is unique so a combination of procedures may be recommended for your particular situation. Recuperation takes time and may vary depending on your condition. Swelling and some discomfort are common for several weeks following surgery but pain is managed with medications and physical therapy as prescribed/recommended by one of our surgeons.

 
[ Back ]