Bunions

What is a bunion?

Bunions are bumps at the base of the big toe and are often associated with drifting of the big toe toward the second toe. A medical tern for the bunion condition is hallux valgus. Bumps at the base of the little toe arc called Tailor's bunions and they are treated similarly to classic bunions.

Symptoms

Bunions often hurt in tight shoewear due to pressure, but can be painful even in well-fitting-shoes. Primarily the pain is at the big toe joint itself, but pain can exist under the ball of the foot. at other toes, or into the arch area of the foot. Painful skin irritations such as corns, calluses, or even open ulcerations may occur.

Causes

Shoes can certainly aggravate a bunion, but they are not usually the cause of the deformity. Hereditary foot structure and arthritis are the most common causes. Other underlying medical conditions may also cause bunions.

Evaluation

A complete history is taken and then a full lower extremity exam is performed. Xrays are often taken, as well, to help further investigate the extent of the deformity.

Treatment

Conservative treatment is often attempted initially, although surgical treatment is sometimes necessary.

Conservative treatments include:
Alteration of footgear. We have a certified pedorthist (shoe specialist) available on staff at The Raleigh Foot Center who can assist in this area. Shoes with plenty of space in the toes as well as good arch support are often the most helpful.
Pads, cushions, and other devices to help keep the toe in alignment and prevent shoe irritation. These devices will not correct the problem but may alleviate some of the pain.
Orthotics (custom-molded supportive insoles) can help maintain alignment and alleviate strain to that area of the foot.
Trimming of associated corns and calluses can help decrease discomfort; however, this usually, needs to be done regularly.

Surgical treatment is usually reserved for patients with pain that is not improved with conservative treatment or whose problem is rapidly getting worse or for a patient who has significant problems fitting shoes. It is performed in a hospital or surgery center and the patient may go home that same day. Sometimes crutches are necessary for a period after surgery. This is often followed by a period where the patient wears a surgical shoe. Crutches and surgical shoes are necessary to protect the newly aligned bones and joints in the foot. Recovery times vary depending on the extent of the deformity.