What is a Bunion?
It is painful swelling on the first joint of the big toe caused by abnormal drifting towards the second toe. Painful bunions are one of the more common conditions treated by Dallas podiatric surgeons. People with bunions usually experience pain when wearing snug fitting shoes or with physical activity, such as walking or running.
What are Bunion Symptoms?
Pain on the side of the foot is the most common symptom associated with bunions and shoes will aggravate this symptom. Prime offenders include stiff leather shoes or shoes with a tapered toe box. As a result, bunion pain is most common in women whose shoes have a pointed toe box. The bunion site is often a little swollen and red from constantly rubbing with the shoe. The rubbing of the first and second toe can also develop corns. On rare occasions, the joint can become acutely inflamed from the development of a bursa (a sac of fluid over the bunion). Bursas are designed to protect and cushion the bone, but can become inflamed. This condition is called bursitis.
What Causes Bunion Deformity?
The classic bunion (hallux abducto valgus) is a bump on the side of the largest toe joint. The bump is present because of a deviation in the 1st metatarsal and is often paired with an overgrowth of bone on the metatarsal head. The big toe also deviates toward the second toe. In severe cases, the big toe can lie above or below the second toe. Shoes are often wrongfully blamed as the cause of these problems. Tribes that typically go barefoot also develop bunions.
Bunions are caused by abnormal foot structure and mechanics, which place an extra load on the 1st metatarsal. This leads to stretching soft tissue structures such as joint capsules and ligaments, resulting in the bunion deformity. Over time, the abnormal pull of tendons causes the big toe to drift towards the second toe and the joint begins to adapt.
The treatment for bunions is usually conservative, involving shoe gear modification, padding and orthoses. Switching to a shoe with a round, deeper toe box made of pliable leather will often provide immediate relief. Pads and cushions reducing the pressure over the bone can also help mild bunion deformities. Functional foot orthotics lessen the deforming forces that lead to bunions and may minimize pain and slow the progression of mild bunion deformities.
If these methods fail to provide relief, surgery may be recommended. Deformity level, x-rays, and procedure discussion are all important when choosing the best bunionectomy. “Shaving the bump” is not recommended because it often doesn’t provide long-term relief and sometimes causes the bunion to progress faster. Most of the surgical procedures involve cutting and repositioning the first metatarsal (osteotomy). For mild to moderate bunion deformities, the bone is often cut near the joint (at the neck). The most commonly performed bunion procedure is the 1st metatarsal neck osteotomy. During the bunionectomy, the bone cut is made near the level of the joint. Other surgical procedures are performed in the shaft or the base of the metatarsal bone.
If you are experiencing these symptoms, request an appointment with us.
Metroplex Foot and Ankle is a progressive group of physicians and surgeons who are committed to helping our patients to achieve their full wellness potential. Contact our Dallas Podiatrist, Garland Podiatrist, or Richardson Podiatrist offices to schedule an appointment today.