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.
