Bunions

Bunions are deformities that occur at the joint at the base of the big toe. The first metatarsal, the first long bone in the foot, shifts outward at the metatarsophalangeal (MTP) joint, creating a protruding bump on the side of the foot and causing the big toe to shift toward the second toe.

The medical term for a bunion is hallux valgus or hallux abducto valgus.

Bunions are usually caused by an inherited faulty mechanical structure of the foot. Having a certain foot type, therefore, makes a person more prone to developing a bunion. Bunions could also be caused due to certain types of arthritis, like rheumatoid arthritis.

While narrow shoes that crowd the toes don’t cause bunions, they can sometimes make the deformity get worse, and as a result, symptoms may appear sooner.

Not everyone has bunion symptoms, but those who do develop them have them appear at later stages. Common symptoms, which occur at the site of the bunion, may include:

• Possible numbness
• Pain or soreness
• Inflammation and redness
• Burning sensation

Since bunions can get progressively worse over time, it is important to get treatment. Initially, they begin with a leaning of the big toe, and over the years, the angle of the bone changes gradually, and the characteristic bump becomes increasingly prominent.

As bunions get larger, they become more painful and may lead to additional problems. Bunions cause the MTP joint to become enlarged, leading to bursitis, an inflammation of the fluid-filled sac that cushions the joint. It can also lead to misalignment of the second toe, as the big toe angles further inward, causing a painful hammertoe.

Sometimes observation of the bunion is all that is needed, and Dr. Tea may schedule periodic evaluations and x-rays to reduce the chance of joint damage.

In other cases, some type of treatment is needed. Early treatments aim to ease the pain of bunions, but they won’t reverse the deformity itself. These options may include:

• Wear the right kind of shoes. Patients should wear shoes that have a wide toe box. Shoes with pointed toes or high heels, which may aggravate the condition, are not recommended.
• Apply an ice pack several times a day to reduce inflammation and pain.
• Avoid activity that causes bunion pain, including staying on your feet for long periods of time.
• Take oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to reduce pain and inflammation.
• Have a corticosteroid injection to treat the inflamed bursa (fluid-filled sac located around the joint).

If nonsurgical treatments fail to relieve bunion pain and the worsening pain starts to interfere with your daily activities, surgical treatment may be your best option.

There are several surgical procedures available to treat bunions. The procedures are designed to remove the bump of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is to reduce pain.

In selecting the procedure or combination of procedures for your particular case, Dr. Tea will consider your age, activity level, and degree of joint deformity (based on the x-ray findings). The length of the recovery period will vary, depending on the procedure or procedures performed.

At Pacific Point Podiatry, Dr. Tea offers both nonsurgical and surgical treatment options for bunions. To schedule an appointment with Dr. Tea, please call Pacific Point Podiatry at (831) 288-3400 or request an appointment online.