Bunions

‘Bunions’ refers to growths on the side of the foot beneath the big toe that results from hallux valgus. When the big toe (hallux) becomes misaligned, the tip of the toe bones may point inward to your other toes.

As the inward point of the big toe worsens, other complications may arise, such as arthritis and tendon problems. The bone directly below the big toe is known as the first metatarsal. The first metatarsal and the hallux create an angle, forming a point on the side of the ball of your foot. A bunion may develop as a response to pressure on this angle, which is often worsened by wearing tight or angled shoes.

Initially, this bump is inflamed tissue. As a bunion progresses, the bone of the foot may also thicken, resulting in a larger bunion that can become more easily irritated by walking or wearing tight shoes. Bunions may be more common in patients who wear pointed shoes, such as high heels or cowboy boots. They are especially common among ballet dancers, who put enormous amounts of stress on their big toes while dancing en pointe.

Symptoms

One of the most common symptoms of a bunion is a large bump or growth on the side of the foot below the big toe. This bump is often tender, swollen, and painful. Bunions can even make it difficult to walk properly, as pain from the bunion may alter a patient’s walking pattern.

Patients with bunions may have difficulty wearing shoes or finding properly sized footwear. Many patients find bunions to be embarrassing and a cosmetic issue. Some cases of bunions can even cause the second toe to move and rub against the shoe frequently, which can cause more inflammation and discomfort.

If the condition is allowed to progress for many years, arthritis can form in the stressed, inflamed joints, making every day life very difficult for the affected individual.

Treatments available for Bunions

Our first-line treatment is usually corrective footwear – bunion pads, toe separators, toe aligners, insoles and orthotic shoes. These can help keep the misaligned big toe pointed in the right direction, and reduce chafing inside the shoe. While these treatments do not solve the problem, they can make this condition more bearable.

In cases where the bunion is particularly large or causing quality of life issues, bunion surgery may be required.

What types of bunion surgery are available?

Several types of bunion surgery can be performed, depending on the severity of the case. These range from a ‘simple’ bunionectomy, which shaves off the offending lump of bone, to much more complicated surgeries that realign the bones of the foot. An orthopedic surgeon that specializes in this type of surgery will be able to help you decide which type of surgery is right for you.

How long does it take to recover from bunion surgery?

This depends enormously on the type of surgery performed.

For patients who undergo a bunionectomy, normal activity can be resumed after a few short weeks of rest, healing and physical therapy. For patients who undergo more complicated surgeries where the bones of the foot are broken and reset, healing time can take several months. Crutches must be used to keep weight entirely off the foot while the bones re-set. A walking cast may be fitted after approximately 4 to 6 weeks.