What are bunions?
A bunion, also known as ‘hallux valgus’, is a deformity of the big toe in which the big toe excessively angles towards the second toe and leads to a bony lump on the side of the foot. This can also form a large sac of fluid, known as a bursa, which can then become inflamed and sore.
What causes bunions and who gets them?
Most often they are caused by a defective mechanical structure of the foot, which is genetic. Fun fact, if your parents or grandparents have bunions, you may be more prone to developing them. Poorly fitting footwear tends to aggravate the problem as tight or narrow footwear can squeeze the forefoot, crowding the toes together and worsen the underlying condition, causing pain and deformity of the joint.
Bunions can also be caused by the big toe pushing or crossing over on to the second and making it difficult to walk due to pressure from footwear. Once the big toe leans toward the second toe, the tendons no longer pull the toe in a straight line, so the problem tends to get progressively worse and can also lead to the development of painful corns and calluses.
Bunions can also be caused by age, arthritis or playing sports. Although anyone can get a bunion, they tend to be more common in women, possibly due to some of the more restrictive footwear typically worn (bunions occur in about 30 percent of the population of most Western countries).
Are they serious?
Some people have large bunions that cause no pain but do cause difficulties with footwear, while others have relatively small bunions that can be very painful. Although some treatments can ease the pain of bunions, only surgery can correct the deformity.
What are the treatments?
Your podiatrist may recommend the following:
- Orthotics (shoe inserts that are customized for your foot type and level of activity)
- Shoe alterations or splints which hold the toes straight and slow the progression of bunions
These are all conservative measures and, although they may help to relieve symptoms, are not a permanent solution to the underlying problem. Your podiatrist is trained to identify significant deformity and may recommend surgical correction which can involve a combination of removing, realigning and fixation of the bone.
Once your podiatric surgeon has evaluated the extent of the deformity, she can remove the bunion and realign the toe joint in a common operation known as a first metatarsal osteotomy (“bunionectomy”). There are many different types of procedures that fall under this title, so each surgery is different based on the individual patient and desired outcome.
The aim of surgery is to address the underlying deformity to prevent recurrence. As with all surgery, there are risks and complications, so it is not usually advised unless your bunions are causing pain or are starting to deform your other toes.
How can I prevent them?
Wearing sensible shoes that fit well is a good preventative measure. If you notice a bump developing where your big toe joins the foot, it may be time to switch your footwear. Choose wider shoes that provide your toes with room to move and keep your heel height to 4cm or less. The following also serves as a useful guide:
- Wear backless, high-heeled shoes in moderation. Backless shoes force your toes to claw as you walk, straining the muscles if worn over a long period.
- Vary your heel heights from day to day, one day wearing low heels and the next day slightly higher heels.
- Wearing a shoe with a strap or lace over the instep holds the foot securely in place and helps to keep your foot from sliding forward.
- Calf stretches to counteract the shortening of the muscles can help to keep feet supple.
When should I see a podiatrist?
If you experience any foot or ankle care issues that do not resolve themselves naturally or through routine care within three weeks, it is recommended that you seek the help of a foot and ankle specialist (podiatrist).
To discuss all of the available options regarding treatment, please contact our office to schedule an appointment with our highly skilled podiatric physician and surgeon.
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Synergy Foot and Ankle Center
1400 North Coit Road Suite 2202
McKinney, TX 75071