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Who ever named it a “bunion?” Probably the same person who named an enlarged thyroid a “goiter”, but seriously, bunions are the common description of a bump on the side of the big toe. Really they are much more than that.
Bunions are known in medical terms as Hallux Abducto Valgus which in English is a crooked big toe joint with a bump on the side. This is actually a progressive misalignment of the big toe joint which starts with a slight leaning of the big toe toward the second and then gradually produces the characteristic bump and joint symptoms. In the late stages of progression, the big toe actually can overlap or underlap the second and cause reactive hammertoes (contracted) of the other toes. Even though they are extremely common, most people wait until they have significant symptoms and deformity before they seek medical attention. Often they have had pain in shoes and with activity for years when they finally come into the office. This is due to the misconception that they always require surgery for treatment.
What causes bunions? No, it’s not always the shoes! (But, they don’t help) Bunions are caused by the faulty biomechanics of your foot structure that you inherited. Couple that with high heeled shoes or even just shoes that crowd your toes (listen up guys who wear cowboy boots!) and you are prone to the formation of bunions.
Symptoms of bunions are the prominent bump with redness from rubbing in shoes, grinding of the joint, pain, swelling, burning and occasionally even numbness.
Diagnosis of a bunion is done by x-ray findings together with physical exam. A bump is not necessarily always Hallux Abducto Valgus, so a complete podiatric exam including x-rays should be done to evaluate your condition. Many people actually have arthritis of the big toe joint or even just a cyst overlying the joint and think they have bunions.
Treatment includes shoe gear modification, an orthotic device to control the abnormal biomechanics, padding, anti-inflammatories or injection therapy to decrease inflammation, and at the later stages, surgery.
When is surgery needed for bunions? If you have pain every day, in every pair of shoes you own (including your athletic shoes) and you have treated your condition with conservative therapy without any relief; it’s time to discuss bunion surgery. Surgery should never be contemplated without pain and activity limitations. There are many advances in bunion surgery and varied procedures depending on your foot type, the stage of your deformity, your activity level, your medical history, and your age. Make an appointment to discuss surgery with your podiatric foot and ankle surgeon if you have progressing symptoms.
The American College of Foot and Ankle Surgeons cites a survey that showed 96% satisfaction after bunion surgery with a board-certified foot and ankle surgeon. 96% of the survey respondents identified pain relief as a desired outcome of the surgery, and 86% also said they hoped to improve their walking and increase their physical activity following surgery. On a scale of 1 to 10 with 10 representing “much pain,” the survey respondents averaged a score of 7 when assessing their pain before surgery, and the average score dropped to 2 when they assessed their pain six months after the operation. 92% said they were able to increase their physical activities -- walking, running, golf, tennis, exercise -- and 90% said they would recommend bunion surgery to others. This is great news! Many people fear the surgery more than pain every day in their shoes! Obviously, this fear is unwarranted!
Fear of surgery should not keep you out of the office because 80% of patients who come in asking for bunion surgery leave with a conservative treatment plan. Call or contact your podiatric foot and ankle surgeon for an appointment today to get your questions answers. Don’t live with the pain of bunions for one more day.
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