One of the more common conditions treated by podiatric surgeons is the painful bunion. Patients with this condition will usually complain of pain when wearing certain shoes, especially snug fitting dress shoes, or with physical activity, such as walking or running. Bunions are most commonly treated by conservative means. This may involve shoe gear modification, padding and orthoses. When this fails to provide adequate relief, surgery is often recommended. There are several surgical procedures to correct bunions. Selection of the most appropriate procedure for each patient requires knowledge of the level of deformity, review of the x-rays and an open discussion of the goals of the surgical procedure. Almost all surgical procedures require cutting and repositioning the first metatarsal. In the case of mild to moderate bunion deformities the bone cut is most often performed at the neck of the metatarsal (near the joint).
The most important causative factor is poor fitting footwear. This accounts for an higher incidence among women than men. Family history of bunions. Abnormal foot function, excessive pronation. Poor foot mechanics, such as excessive pronation (rolling inwards of the foot), causes a medial force which exerts pressure and can lead to the formation of bunions. Rheumatoid or osteoarthritis. Genetic and neuromuscular diseases, which can result in a muscular imbalance such as Down's syndrome. If one leg is longer then the other, the longer leg is more inclined to develop a bunion. If the ligaments in the feet are very weak. In some cases, bunions can occur due to trauma or injury to the feet.
A bulging bump on the outside of the base of your big toe. Swelling, redness or soreness around your big toe joint aggravated by footwear. Red, calloused skin along the inside edge of the big toe. Corns or calluses under the ball of the foot or where the first and second toes overlap. Persistent or intermittent pain. Restricted movement of your big toe.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Getting rid of a Bunion is almost impossible without surgery. Foot and toe exercises can help. Foam pads can reduce the pressure on the joint. Ice packs and anti-inflammatory medication can help reduce swelling. The progress of a Bunion can be slowed or even halted, especially if it is caused by ill-fitting footwear. Of course the best course of action is to not wear pointy-toed high-heel shoes to begin with. But if you have worn improper footwear and now want to stop the progress of Bunions.
For severe bunions, outpatient surgery may be recommended. Within hours after surgery, you?ll be on your way home and ready for recovery. Your foot will be bandaged following surgery and placed in a surgical shoe which allows you to remain mobile. Immediate weight bearing without the use of casting or crutches is standard post- operative recovery for bunions. In most cases, the majority of healing should occur within a few weeks and you can resume normal activity within a short period of time. Bunion surgery can both reduce pain and improve the appearance of your feet. After surgery it is important to see your podiatrist as scheduled and follow all recovery instructions.
Make better shoe choices. If you?re a woman, avoid high-heeled footwear whenever possible (at the very least, choose shoes with heels lower than two inches), and make sure all your footwear has a wide, deep toe box. Whether man or woman, if you?re trying on shoes and your toes feel ?squished? or crowded by a particular shoe, reject that style and try another, or go for a larger size. You don?t need to invite trouble. In general, shoes that come to a point at the toe are bad news, as they tend to push the toes together into an overlapping pattern. Shoes with rocker soles will unload pressure on the bunion area. Examine your feet regularly. Note any redness, swelling or discoloration. Flex your toes and check for any stiffness. If there is any, think back to what you?ve worn or done in the past few days. If the condition persists more than a few days, or worsens, a visit to the podiatric physician is in order.