Weekend Doctor: Bunions

A bunion (also known as hallux abducto valgus) is a bump on the inside of your foot at the big toe joint. The bump is not an enlarged bone, but rather an abnormal bend of the first metatarsal bone on the inside of your foot. In addition to the bump, the big toe also begins to drift toward the other toes, which can cause them to bend as well. Bunions can be hereditary, they can develop overtime due to biomechanical issues of the foot, they can be caused by systemic medical issues or they can be caused secondary to trauma to the big toe joint.

Symptoms of a bunion can include pain or soreness, inflammation and redness, a burning sensation and numbness. Certain types of shoes can make these symptoms worse, but certain shoe types do not actually cause bunions, which is sometimes a common misconception. In evaluating a bunion, your practitioner will likely examine your foot structure, examine your big toe joint and order X-rays of your foot. Bunions are progressive and can become larger over time. Treatment options include both conservative and surgical options.

Conservative treatment options focus on symptom relief. They include shoe gear modification (wearing shoes with a wider toe box or special padding), activity modification, over the counter pain medication, topical medications, icing, injections and orthotics.

If conservative therapy fails and the pain caused by the bunion interferes with work or activities of daily living, then surgery may be an option. There are a wide variety of bunion procedures depending on the severity of the bunion, your foot structure and presence of arthritis in the big toe joint or surrounding joints. Surgery focuses on getting rid of the bump and realigning the bones around the big toe joint, either with bone cuts or joint fusions. Pins, screws and plates may all be used to help hold the correction in place. Recovery time will vary based on the procedure selected by you and your surgeon. Non-weight-bearing recovery for the affected foot can range from three to eight weeks. 

If you are concerned that you may have a troublesome bunion, talk to your orthopedic/podiatric provider today.

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