A bunion (also referred to as hallux valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment—producing the bunion’s bump.
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited but certain foot types that make a person prone to developing a bunion, such as over-pronation.
Although wearing shoes that crowd the toes will not actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.
Symptoms, which occur at the site of the bunion, may include:
- Pain or sorenessc
- Inflammation and redness
- A burning sensation
- Possible numbness
Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.
Bunions are readily apparent—the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, your Calgary foot doctor may take x-rays to determine the degree of the deformity and assess the changes that have occurred.
Because bunions are progressive, they do not go away and will usually get worse over time. But not all cases are alike—some bunions progress more rapidly than others. Once your Calgary foot surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Sometimes observation of the bunion is all that is needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised.
In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they will not reverse the deformity itself.
Changes in shoes. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels, which may aggravate the condition.
Padding. Pads placed over the area of the bunion can help minimize pain. These can be obtained from your surgeon or purchased at a drug store.
Activity modifications. Avoid activity that causes bunion pain, including standing for long periods of time.
Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
Icing. Applying an ice pack several times a day helps reduce inflammation and pain.
Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
Custom Orthotic. In some cases, custom orthotic devices may be provided by your Calgary podiatrist to help control the faulty biomechanics that cause bunions. These orthotic devices do not stop the progression of the bunion, nor do they get rid of it, they simply slow the progression of the bunion.
When Is Surgery Needed?
If nonsurgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it is time to discuss surgical options with your Calgary foot and ankle surgeon. Together we can decide if surgery is best for you.
A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the bump of bone, correct the changes in the bony structure of the foot and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain and deformity.
As a general rule, Bunion Surgery procedures are performed on an out-patient basis in an Alberta Health Services (AHS) approved Surgical Center or in a Hospital. Surgical procedural costs are covered by AHS or the patient may opt for private surgery to avoid a waiting time. A visit to Feldman & Leavitt Foot And Ankle Specialists will CLEARLY define all available patient options.