Bunions (Hallux Valgus)

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A bunion is a common condition that involves an abnormal, bony bump at the base of the big toe, causing the joint to swell outward and become painful. The big toe may also turn inward toward the second toe as a result of the enlarged joint, which can then lead to difficulty walking, ingrown toenails and corns and calluses.

Bunions can form when there is an improper balance of forces exerted on the joints of the foot, causing instability in the joint of the big toe. This often occurs as a result of shoes that do not fit properly, abnormal walking habits or an inherited foot type. Bunions can also be caused by injury, birth defects, arthritis or certain neuromuscular disorders.

Although bunions are not usually a serious condition, they can be painful and embarrassing. If left untreated, they will usually grow larger and more painful over time. It is important to seek medical attention and discuss treatment options with Dr. Deland.

Bunion treatment depends on the severity of the condition, although early treatment is considered most effective. Mild bunions may be relieved of pain simply by changing shoes, applying ice or taping your foot into a normal position. Medication, orthotics and physical therapy may also be recommended by Dr. Deland. Surgical treatment, usually reserved for more severe cases, can improve pain, inflammation, deformities and stiffness.

Medication

While Tylenol can be taken to control pain, anti-inflammatory drugs (NSAIDs) may be more effective in both relieving pain and reducing inflammation. Cortisone injections may also be used.

Orthotics

Padded shoe inserts help restore the foot to a normal position and restrict any abnormal movement. While over-the-counter inserts may help, custom-made orthotics are usually much more beneficial.

Physical Therapy

The pain and inflammation of bunions can often be reduced through therapeutic techniques such as ultrasound therapy or whirlpool baths.

Surgery

Surgery to treat bunions is often used for more severe cases, or after conservative treatment methods have failed. There are several different surgical options available, depending on the cause and symptoms of the bunion.

The most common surgical procedure for bunions is a bunionectomy, which includes:

  • Removing the swollen tissue from the big toe joint
  • Removing part of the bone to straighten the big toe
  • Permanently joining the bones of the big toe joint

A bunionectomy may be performed alone or in conjunction with other procedures that may:

  • Shave off the swollen bump
  • Repair the tissue in the joint
  • Fracture and realign the bones of the toe
  • Remove part of the bone to decrease the angle of the toe
  • Remove the bump on the toe joint

Some of these procedures will require the use of metal screws, wires or plates to hold the joint structures together, especially after pieces have been removed. Dr. Deland will help you decide which procedure will be most effective for your individual condition after evaluating your medical history and X-ray images.

Most bunion procedures are performed on an outpatient basis under local anesthesia. General anesthesia may be used in certain situations depending on the complexity of the procedure and the preference of the patient. Complications from these procedures are rare but may include infection, recurring bunion or nerve damage.

Recovery

Recovery from bunion surgery depends on the complexity of the procedure. Some people will be able to walk on their foot immediately after surgery, while others may need to use crutches or a cane and may not be able to walk for a few weeks or longer. It is important to keep your dressing clean and dry to ensure proper healing. Most patients require the use of orthotics after surgery in order to maintain stable and correctly-positioned feet.

While these procedures can be beneficial, they are usually only recommended for patients with bunions that cause severe pain. There is also a chance that a bunion may form again after surgery. Patients with realistic expectations are usually satisfied with the results of their surgery.

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