Bunions

There is misinformation and confusion about bunion deformities.  Our article (Plain Talk About Bunions - found in the section on foot deformities) will explain how bunions develop, what can be done and most importantly what should not be done.  Also see our Newsletter on Bunions.  Dr. Young is a board certified foot surgeon with over twenty five years of experience.  She is familiar with the history of bunion treatments and surgery and she is trained in state of the art modern procedures.  This article is her opinion based on that experience.

WHAT IS A BUNION?

A bunion is an enlargement or bump just behind the big toe.  This bump is formed by the movement of the joint and not usually a large growth of bone.  The foot appears wider.  Nerves and vessels are in the skin overlying the bunion joint.  Over time, and in certain shoes or even while lying in bed, the pressure over the  joint hurts or becomes numb. 

A foot that rolls inward (pronates) seems to cause and lead to many foot problems such as hammer toes, heel spurs and bunions.  When a person walks on this weakened foot structure, joints slowly move out of position.  Secondly, muscles that control these joints maintain the bunion deformity and worsen it.  This means that once the bunion deformity starts it will be maintained and worsened if not properly treated. 

Please refer to the diagram to aid in your understanding of a bunion deformity.  It shows the muscles that pull at an angle on the big toe.  Once this process gets started, your muscles and tendons act in a misaligned or crooked manner.  This explains why bunions only get progressively worse and never improve or get straighter.  This also explains why the foot gets wider and shoes get tighter when a person has a bunion.


 

More than half of the women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes. But often bunion deformities are seen without wearing improper shoes. They can also occur in the teenaged years and can be quite severe. Bunions cause the base of your big toe (Metatarsophalangeal Joint) to enlarge and protrude. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful.

Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Most bunions can be treated without surgery by wearing protective pads to cushion the painful area, and of course, avoiding ill-fitting shoes in the first place.

Bunion surgery, or bunionectomy, realigns the bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Bunion surgeries are performed on a same-day basis (no hospital stay). They are generally very successful surgeries with excellent results. Improvement in procedures and instrumentation have enabled consistently good and permanent results.  See my booklet Plain Talk about Bunions for more information.