Bunions (Hallux Valgus)
Bunions are one of the most common reasons patients visit a podiatrist. Bunions are a deformity that is caused when the big toe (Hallux) drifts towards the lesser toes, creating a painful bump on the inside of your foot. Bunions are usually genetic in nature, and most patients with bunions have a family history of the deformity. In general, a person's foot structure, which is determined mostly by genetics, plays a large role in pre-determining whether or not you will have a bunion. Improper shoes are not the cause of bunions, but they can cause increased pain and speed up the rate at which the bunion progresses.
Over time, the hallux will continue to drift further towards the other toes, and will sometimes cross over or under the 2nd toe. As the hallux spends more time in a deformed position, arthritis can start to form in the great toe joint, leading to increased pain and decreased function. Additionally, as the bunion progresses, the big toe pushes the other toes out of the way, leading to hammertoe deformities.
When Should You Seek Treatment For Bunions?
This is the most commonly asked question among patients with a bunion deformity. Luckily, there is a simple answer... Only if the bunion causes pain! If you do not have any pain associated with your bunion, you have to consider that treatment, whether conservative or surgical, may cause some level of discomfort, which would be more than what you had to begin with. If you only have pain with wearing certain shoes, you may need to consider other shoe options.
If your pain is consistent, and you are limited from your activities, work, or shoe options, then you should consider treatment for your bunion.
Evaluation of Bunions involves examination of the entire foot structure, not just the great toe joint. The presence of arthritis, ligament laxity, or other foot deformities can play a critical role in the potential success of your treatment, and overlooking these key elements may lead to poor outcomes.
Like most deformities, there are two treatment options: manage the symptoms or fix the problem. Unlike most conditions of the foot and ankle, bunions have limited options for conservative treatment. Shoegear changes, accommodative padding, and anti-inflammatory medications are ways to temporarily manage the pain associated with bunions.
The only way to correct, and permanently fix, a Bunion is with surgery. Since there is a deformity present, reconstructive surgery is necessary to re-align the great toe joint. Surgery generally consists of shaving the prominent bump, making an osteotomy (bone cut), and realigning the joint. One or two screws may be used to hold the bone in place, and they remain in your bone for the remainder of your life, with a less than 5% removal rate. The foot is protected in a boot for 3-4 weeks. A surgical shoe is used for an additional 2-3 weeks before transitioning back into your normal shoes. Physical Therapy may be utilized during the recovery period, to keep the joint from becoming stiff after surgery.
If the deformity is severe, or if arthritis has started, there may be need for an arthrodesis (fusion) type procedure. The recovery time is increased with this procedure, but the outcomes can be much more predictable when correcting severe deformities.
We are happy to discuss what treatment option may be best for you. If you have been suffering with Bunion pain, Call us at 512-593-2949 or CLICK HERE to Schedule an Appointment.