Overland, KS Bunion
A patient I’ll call “Carole” came to my office recently for a consultation. Carole is a 33 year old runner with had runner’s toes and bunions. Runner’s toes get black and blue, thickened, and sometimes develop secondary fungal infections. We talked about shoe modification and using vaseline to miniimize the friction on the toes. Regarding the bunion, she didn’t want to have surgery because she heard it was a very painful operation. Carole wondered if there was a splint she could use.
What is a bunion? A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. Bunions certainly have had a reputaion for being a painful operation. However significant advances have been made in the last 30 years eliminating much of the pain post operatively. The moderate bunion, most of what we see and treat (and what Carole had), takes less than 30 minutes to do under general anesthesia. Taking pain medication that night before the long acting local wears off helps one sleep through the night. Ice is the trick the next day, especially after getting up to go to the bathroom. Ice helps to take the sting and throbbing out when resting with the foot elevated. Many patients have little or no pain.
Our typical patient is able walk on their foot right away for short periods. A cast, boot, or post-op shoe allows the patient to put weight on the outside of the foot, kind of like a “duck walk”.
The procedure I do is unique in that my incision is on the side where one does not see the scar for the moderate bunion. The bump is removed, then the joint is realigned so the toe is straight. I do this by taking an additional wedge out of the bone to correct the alignment. I have over 35 years experience doing this procedure. Other new techniques have helped to speed the recovery.
Wearing shoes that are too tight is the leading cause of painful bunions. Bunions are hereditary, and tend to run in families, usually because of a faulty foot structure. Bunions are seen in barefoot populations. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second, to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.
Our office would be happy to answer any questions you might have about the minimal disability and pain associated with bunion surgery. Please contact us at 913-438-9898.