BUNIONS

What is a bunion?

A bunion is one problem that can develop due to hallux valgus, a deformity of the foot. The Latin meaning of “hallux valgus” is: turning outward (valgus) of the first toe (hallux). The bone which joins the first toe, the first metatarsal, becomes prominent on the inner border of the foot. The pressure on this prominence causes inflammation and pain. This is the bunion.

Other problems can develop along the hallux valgus. The metatarsal bones can become prominent in the ball of the foot and the lesser toe joints can become contracted. With shoe pressure, corns and calluses develop.

What is the cause?

There is no single cause of hallux valgus. It may develop from muscle imbalance, as in cerebral palsy or polio. It may develop from joint destruction as in arthritis. The most common cause is an imbalance of forces on the toe present from birth, which causes the hallux valgus to develop progressively with time.

High heeled, pointed toe shoes are not the primary cause of the deformity but they do cause it to be painful. They cause bunions, corns and calluses to develop where there is deformity.

What is the treatment?

Before treatment of a painful bunion can begin, medical evaluation is needed to rule out osteoarthritis, rheumatoid arthritis, infection and gout, these can all cause pain in the first toe. Circulatory problems not only cause pain but also cause serious complications if surgery is attempted. Diabetes and cigarette smoking cause diminished healing potential and a tendency toward infection.

Treatment may be surgical or non-surgical. The goal of non-surgical treatment is to relieve pressure on the foot and to prevent pressure sores and foot ulcers. This is accomplished by prescribing accommodative shoes with a wide toe box like sandals or extra depth shoes with soft molded insoles. It may also be possible to relax the leather on shoes to make room for a bunion.

Surgery can correct your painful bunions. The age of the patient and the deformity of the foot will determine the type of surgery your surgeon will recommend. X rays are necessary to help plan for your surgery. Your surgeon will discuss your specific surgery in detail. Surgery attempts to realign and balance the first toe to restore normal function. Corns on the lesser toes are treated by straightening and shortening the toes.