A bunion is an enlargement of a long bone in the foot known as a metatarsal. This enlargement is near the base of the big toe and involves the metatarsophalangeal joint (MPJ). This boney prominence can result in painful big toe joint range of motion, resulting in limping and inability to wear shoes and participate in activities. Besides restricting joint range of motion, bunions can serve as a source of nerve pain when the abnormal bone presses on shoes and irritates the nerve. In some cases, if left untreated, bunions can lead to ulcerations and limb compromise.
Bunions have a tendency to be inherited and more common in women than in men. Bunions are most frequently aggravated by tight and narrow shoes.
Bunions can make wearing shoes difficult and be more unsightly as time progresses. Bunions, if left untreated, tend to get worse with time and may under-lap or overlap adjacent toes and cause deformities and hammer toes of neighboring toes which may negatively affect the proper function of the smaller toes further creating an abnormal gait and affecting weight distribution required by the body.
Conservative treatment for bunions may entail shoe changes, medications and injections. Prior to surgery your podiatrist may recommend a custom arch support in which wet plaster is molded to the foot to capture the foot’s deformities from which an arch support unique to only your foot is fabricated and placed under the foot to slow down deforming forces responsible for bunion formation.
For those failing to respond to good conservative care surgical correction may be necessary. Proper preparation for surgery involves taking x-rays to analyze the bone’s structure and extent of the deformity and selection of surgical procedure. Surgery is done on an outpatient basis and will require medical clearance from your primary care physician. Post-operatively the patient will have to wear a cam walker and will have very specific weight bearing / non-weight bearing instructions from their surgeon.
