Even though bunions are a common foot condition, they are probably the one with the most misconceptions. Many people suffer unnecessarily with the pain of bunions for years before seeking treatment out of fear about the ?surgery?. The good news is that most bunion pain can be resolved without surgery.
Hereditary and shoe gear are probably the most likely causes. Tight pointy shoes (and high heels) may promote the formation of a bunion. A bunion may develop rapidly or develop slowly over time. Some people have bunions in their teens while others only develop a bunion later in life. Bunions come in a variety of sizes – from small to severe. In some cases, the big toe may push against the second toe, and may result in pain and a hammer toe, or progress onto a severe disfiguring foot deformity. Depending on your overall health, symptoms and severity of the bunion, the condition may be treated conservatively and/or with surgery.
SymptomsIf you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.
Non Surgical Treatment
If overpronation is diagnosed early enough, the mechanics of the feet can be adjusted using a prescription orthotic. If orthotics are worn consistently, many major foot deformities can be avoided such as bunions. Early detection is of paramount importance. When a bunion progresses and cannot be controlled by an orthotic, surgical correction may be a consideration. Many advances in bunion correction allow for surgical intervention to make healing and return to normal activities much easier than use of traditional bunion surgery.
There is no “standard” bunion, but rather a complex range of joint, bone, muscle, tendon and ligament abnormalities that can cause variation in each bunion’s make-up. As a result, there are a broad variety of surgical techniques for dealing with bunions. Most surgical procedures start with a simple bunionectomy, which involves excision of swollen tissues and removal of the enlarged boney structure. While this may remove the troublesome tissues, however, it may not correct other issues associated with the bunion. The surgeon may also need to tighten or loosen the muscles, tendons and ligaments around the MTP joint. Realign the bone by cutting it and shifting its position (a technique called osteotomy), realigning muscles, tendons and ligaments accordingly. Use screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.
There are some steps that may help prevent, or at least slow, the progression of bunions. Avoid shoes with a narrow toe box. If your foot flattens excessively, make sure you wear supportive shoes, and if necessary, get custom orthotics from your podiatrist. See your podiatrist at the first signs or symptoms of a bunion deformity, as early treatment may stop or slow its progression.