Bunions are
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. With a bunion, 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 continues to become
increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people
never have symptoms.
What Causes a Bunion?
Bunions are most often caused by faulty mechanics of the foot. The deformity runs in families, but
it is the foot type that is hereditary, not the bunion. Certain foot types make a person prone to developing
a bunion.
Although wearing shoes that crowd the toes won't actually cause bunions in the first place, it sometimes
makes the deformity get progressively worse. That means you may experience symptoms sooner.
Symptoms
Symptoms occur most often when wearing shoes that crowd the toes-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.
Symptoms, which occur at the site of the bunion, may include:
- Pain or soreness
- Inflammation and redness
- A burning sensation
- Perhaps some numbness
Other conditions which may appear with bunions include calluses on the big toe, sores between the toes,
ingrown toenail, and restricted motion of the toe.
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 more rapidly than others. Once your podiatric surgeon has
evaluated your particular case, a treatment plan can be developed that is suited to your needs.
Early treatments are aimed at easing the pain of bunions, but they won't reverse the deformity itself.
When Is Surgery Needed?
When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with
your podiatric surgeon. Together you can decide if surgery is best for you.
Recent advances in surgical techniques have led to a very high success rate in treating bunions.
Many surgical procedures are used to correct bunions. The decision to employ a procedure is based on
the severity of the deformity, the patient's age, the general health of the patient, their activity
level, and the general health of the bones and connective tissue. Other factors may influence the choice
of a procedure used.
The general guidelines for types of surgery are: Mild Bunion, Moderate Bunion, Severe Bunion and Arthritic
Bunion or big toe joint.
For a mild bunion, the podiatric surgeon may remove the enlarged portion of bone and realign
the muscles, tendons and ligaments surrounding the joint.
For a moderate bunion, the podiatric surgeon may cut the bone and shift it to its proper position.
Whether or not the bone is cut depends on the severity and location of the deformity. In addition, the
surrounding tendons and ligaments may need to be repositioned.
For a severe bunion, a combination of the following procedures may be necessary: removal of
the enlarged portion of the bone; cutting and realignment of the bone; and correction of the tendons
and ligaments.
If the joint is destroyed beyond repair (commonly seen in arthritis), it may need to be reconstructed
or replaced with an artificial joint. Joint replacement implants may be used in the reconstruction of
the big toe joint.
After the foot has healed, and if the bunion was a result of improper foot function or foot type, the
cause of the problem should be addressed. Orthoses may be prescribed to protect the foot and improve
its function. Guidelines may also be provided by the podiatric surgeon on the types of shoes that should
be worn. These instructions should be followed carefully to avoid recurrence of the bunion.
Ask your physician about surgical procedures to correct bunions at Lourdes.