Bunions are a progressive deformity that results from mechanical imbalance and undue stress on the big toe joint. The leaning of the big toe toward the second toe throws the bones of the foot out of alignment, causing a protuberance of bone or tissue around the joint.
Contrary to popular belief, bunions are aggravated, not caused, by shoes. The late anthropologist Margaret Meade observed many members of a South Sea island tribe had bunions, yet they had never worn shoes. They usually are the result of inherited faulty foot mechanics that put abnormal stress on the front of the foot. Women significantly outnumber men among bunion patients because wearing high-heeled shoes aggravates the condition. Spending long periods of time on your feet can also make the condition worse. Because bunions are a progressive disorder, it is best to see a foot and ankle surgeon for diagnosis and intervention that can correct the problem before severe pain and deformity can occur.
Pain from a bunion can be mild, moderate or severe, making it difficult to walk in normal shoes. The skin and deeper tissues around the bunion may be swollen or inflamed. Other toes can be affected too, from pressure applied by the movement of the big toe joint against them. Bunions usually get worse over time. Pressure can develop on the adjacent toes by the drifting of the big toe joint. Diagnosis involves a clinical examination of the foot and lower extremity in weight bearing and non-weight bearing positions, as well as a radiographic examination of the deformity.
Early treatments are aimed at easing the pain of bunions but they do not reverse the deformity. Pressure is lessened by padding the joint, wearing comfortable shoes or foot orthotics. Anti-inflammatory drugs and ice may be recommended for relief of pain and swelling. Activities that cause bunion pain should be avoided.
When the pain and deformity of a bunion have progressed beyond the limits of non-surgical treatment, surgery may be recommended. The doctors at the Associated Foot Clinic will select a procedure based on the patient’s age, activity level, and the degree of deformity. Following surgery, the patient usually wears a surgical shoe or a cast. The length of the recovery period will vary depending upon the procedure or procedures performed.