Bunions (also referred to as hallux valgus or hallux abducto valgus) are deformities that occur at the joint at the base of the big toe. The first long bone in the foot, called the first metatarsal, 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 visible bump actually reflects changes in the bony framework of the front part of the foot. 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 that often worsens over time, particularly without proper treatment. 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 becomes increasingly prominent.
As the bunion gets larger, it becomes more painful and may lead to additional problems. Bunions cause the MTP joint to become enlarged, which may lead 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.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.
Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may, therefore, appear sooner.
Bunions are readily apparent–the prominence is visible at the base of the big toe or side of the foot. However, to evaluate the condition fully, Dr. Neitzel may need x-rays to determine the degree of the deformity and assess the changes that have occurred.
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 Dr. Neitzel has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
There are both nonsurgical and surgical treatment options available to treat bunions.
Nonsurgical Treatment Options
Sometimes observation of the bunion is all that is needed. To reduce the chance of damage to the joint, Dr. Neitzel may schedule periodic evaluations and x-rays. She may also recommend custom orthotics to change the way the foot is interacting with the ground, thus slowing the progression of the deformity.
In many other cases, however, some type of treatment is needed. Early treatments are aimed at easing the pain of bunions, but they won’t reverse the deformity itself. These include:
In most cases, addressing the deformity through the use of custom orthotics is the most effective way of slowing the progression of this condition and improving the patient’s comfort level.
Surgical Treatment Options
If nonsurgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it is time to discuss surgical options with Dr. Neitzel. Together you can decide if surgery is best for you.
A variety of surgical procedures are 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 the reduction of pain.
In selecting the procedure or combination of procedures for your particular case, Dr. Neitzel will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
At Peninsula Podiatry, Dr. Neitzel offers a full range of nonsurgical and surgical treatments for bunion relief. If you would like to schedule an appointment with Dr. Neitzel, please call (360) 443-5632 to schedule an appointment.
