What Is a Bunion?

A bunion (also known as hallux valgus or hallux abducto 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. Signs and symptoms usually appear at later stages, although some individuals never have symptoms.


Causes

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. Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Signs and symptoms may therefore appear sooner.


Signs and Symptoms

Symptoms, which occur at the site of the bunion, may include:
• Pain or soreness
• Inflammation and redness
• A burning sensation
• Possible numbness
Symptoms occur most frequently 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.


Diagnosis

Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to completely assess the problem, Blue Ridge Foot and Ankle Clinic may take x-rays to find out the degree of the actual deformity and assess the changes that have occurred.
Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress faster compared to others. Once Dr. Murray or Dr. Chang has evaluated your bunion, a treatment plan can be developed that is suited to your needs.


Non-Surgical Treatment

Sometimes observation of the bunion is all that’s needed. To lessen the risk of harm to the joint, periodic evaluation and x-rays by Dr. Murray and Dr. Chang are advised. In most other cases, however, some kind of treatment is needed. Early remedies are targeted at easing the pain of bunions, however they won’t reverse the deformity itself. Included in this are:
• Modifications in shoewear. Wearing the correct type of shoes is essential. Choose shoes which have a wide toe box and forgo those with pointed toes or high heel shoes which may worsen the situation.
• Padding. Pads positioned on the area of the bunion might help minimize pain. These can be obtained from your surgeon or purchased at a pharmacy.
• Activity adjustments. Stay away from activity that triggers 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 many times a day helps decrease inflammation and discomfort.
• Injection therapy. Although hardly ever used in bunion treatment, injections of corticosteroids may be beneficial in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
• Orthotic devices. In some cases, custom orthotic devices may be provided by Dr. Murray and Dr. Chang.


When Is Surgery Needed?

If non-surgical treatment options neglect to relieve bunion pain and when the pain of a bunion disrupts daily activities, it’s time to talk about surgical options with Dr. Murray and Dr. Chang. Collectively you can determine if surgery is best for you. A number of surgical procedures exists to treat bunions. The procedures are designed to remove the “bump” of bone, correct the changes in the bony framework of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain. In choosing the procedure or combination of procedures for your particular case, Blue Ridge Foot and Ankle Clinic will take into account the degree of your problems based on the x-ray findings, your age, your activity level, and other factors. The length of the recuperation period will differ, depending on the procedure or procedures performed.

Surgery

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