A bunion is a painful enlargement of the base of the big toe that develops gradually over a period of years. Generally, patients who develop bunions have a prominent joint at the base of the big toe, abnormal angulation of the big toe towards the other toes of the foot, a degree of skin irritation at the joint and significant pain especially with ambulation. I hope to give you some information about surgical and non-surgical ways to treat bunions as well as provide you with information about how to avoid the formation of bunions.
First, let’s talk about some of the causes of bunions. Although there is a hereditary component to bunion formation, heredity only accounts for a small percentage of cases. Most of the time, bunions are the cumulative result of poor shoe choices, poorly fitting shoes, and abnormal biomechanics of the foot. The three of these combine together to cause a repeated stretch with every step that gradually stretches out the base of the big toe leading to formation of the bunion.
You might be surprised that most people buy shoes for themselves that do not fit. As a matter of fact, the American Orthopaedic Foot and Ankle Society demonstrated that well over 80% of women wear shoes that are too small for them. When buying shoes, I encourage patients to:
- Have both of their feet measured. There is often a variation in shoe size from one foot to another. If you have feet that are two different sizes, buy shoes to the size of the larger foot.
- Not just focus on shoe size when selecting the right shoe. Sizes vary among manufactures and you need to assure proper fit to promote healthy feet.
- Stand during the fitting process and make sure there is about a half inch of space between the end of the shoe and your big toe.
- Buy shoes that fit the width of your foot as well. Shoes that compress the toes together or the middle of the foot can lead to a variety of problems.
I invite you to take a second look at the footwear you presently own to make sure that each pair fits the way it should. The sizes of your feet change as you age. Also, they change during the day; getting larger as the day progresses.
Treating bunions usually starts with non-surgical interventions. Modification of shoe wear, following the rules we have previously discussed, is an important first step in controlling the pain. Also, orthotics can be helpful in correcting the biomechanical issues that place abnormal pressures through the foot. Orthotics are devices placed in the shoe between your foot and the sole of the shoe. They minimize abnormal motions. Often, store bought orthotics are sufficient, but there are times when custom orthotic intervention is recommended.
The discomfort associated with bunions can sometimes be relieved with either oral medications or even injections. Although these can be successful in controlling the pain associated with bunions, it is important to understand that the only way to cure the actual bunion is with surgical intervention. The vast majority of patients who undergo this procedure are satisfied with the results. As a matter of fact, nearly 90% of patients who undergo the surgery are satisfied with the results in terms of pain reduction and improved appearance of the foot. There are a variety of surgical techniques that can be performed.
The process starts with your initial evaluation and a radiographic evaluation. Together, we will discuss the options that will help you the most. If you want to learn more about bunions, I invite you to visit the Agility website at www.agilitydoctor.com and listen to a podcast or audio message I recorded that further describes the evaluation and treatment of bunions.