Bunions are a common foot condition and source of foot pain and discomfort for millions of people. They develop due to an imbalance in foot mechanics, and the great toe starts to crowd the lesser toes. The abnormal foot mechanics cause a bump on the inside of the foot. Abnormal foot mechanics, and ultimately bunions can be caused by tight shoe wear, genetic factors, or repetitive stress causing degenerative changes. A similar condition can also occur on the outside of the foot, referred to as a bunionette.
Bunions are often painful and make walking and daily activity difficult for some individuals. The skin and tissue around the bunion is often swollen, red, and inflamed. Severe bunions sometimes decrease the movement of big toe. The pain and tenderness make it very difficult to wear shoes or find shoes that fit comfortably.
Diagnostic Testing for Bunions
Our physicians will ask a series of questions and perform through physical exam of the foot. Our team will perform x-rays of the foot in a weight bearing fashion to properly evaluate the foot structure. If bunion correction is needed, the x-rays guide the proper treatment plan. Advanced imaging (MRI or CT) is typically not needed but in some cases may be used to rule out other conditions.
Non-Surgical Treatment for Bunions
In milder cases, non-surgical remedies can be helpful. Conservative treatments include; wearing wide shoes, shoe/boot modifications, anti-inflammatory medications, and even bracing or taping. All these are used to help reduce symptoms and make the bunion more manageable.
Surgical Treatment for Bunions
In severe cases, surgery may be needed to remove the bunion. A number of surgical treatments are available for the removal of a bunion. Typically, bunion removal surgeries will involve a bunionectomy which is shaving of the bump. The surgery also involves balancing the soft tissues around the great toe. In most cases osteotomies, or bone cuts, are needed in addition to simply removing the bump. These bone cuts decrease the risk of recurrence of the bunion and correct the mechanics of the foot. There are many different types of osteotomies and our orthopaedic surgeons choose the best osteotomy for each patient depending on their x-rays.
Post-Operative Treatment of Bunions
Surgical intervention is typically done in as outpatient surgery (meaning no overnight hospital stay). A nerve block is often used to minimize pain after surgery in addition to oral medications. The foot is wrapped and the patient is placed in a hard sole (postoperative) shoe. Depending on the surgery done, a period of 4-6 of non weight bearing is possible. Some patients can weight bear almost immediately, but this is determined on an individual basis by the orthpaedic surgeon. It is absolutely essential that patients follow the protocol for post-op recovery as set forth by our team as it remains a crucial part of the heeling process. To prevent bunions from reoccurring, patients will need to find comfortable shoes that provide adequate room and movement of the toes.