Bunions are one of the most common foot deformities we see at our office. In this condition, the largest toe (on one or both feet) slowly drifts out of alignment, pushing into the neighboring toes. At the same time, a bulging, bony enlargement forms and grows at the base of the toe, which can cause all sorts of problems like pain, swelling, corns, calluses, difficulty walking, restricted toe movement, and more.
Unfortunately, may people will wait years—even decades—before deciding to do anything about bunions. Many did not even know anything could be done until the pain became unbearable. We’re here to dispel that misconception—you can find relief for your bunion pain, and the sooner you seek help, the better. In most cases, quick action can help you find relief while bypassing surgery entirely.
Tracking Down the Culprit
There’s still some disagreement within the medical community over whether or not wearing bad footwear truly “causes” bunions, or if they merely accelerate the development of an issue that’s already there.
What we do know is that, in practice, most cases have both a genetic and an environmental component. Some people simply have naturally inherited foot structures that are less adept at handling or distributing impact forces, and more naturally prone to bunion formation. If you have a mother (or father) who has bunions, there’s a very good chance that you will, too.
On the other hand, there is also a high correlation between bunions and wearing shoes that constrict toes, put too much weight too far forward, or both (for example, high heels with narrow pointed toe boxes). Whether or not they can cause a bunion in a healthy, well balanced foot is an open question, but it can certainly destabilize a joint that’s already prone to drifting out of place.
Treatment Approach 1: Conservative Care
Not every bunion requires surgery. Although conservative care won’t “fix” a bunion (the bump will still be there), it can stop further progression and help you walk without pain in cases where the bunion is not yet severe. You have to take action early, however—the further along your bunion gets, the more likely you’ll need surgery.
Conservative treatment for bunions may vary on a case-by-case basis: it’s important for us to ascertain the exact causes and severity of your current condition to determine the best package of countermeasures. However, it may frequently include the following:
- A new pair of shoes with more support and room in the toe box—in the mildest cases, this alone may be enough
- Shoe inserts or custom orthotics, which help accommodate structure deficiencies in foot shape and redistribute or cushion impact forces
- Taping or splinting the toe in a normal position
- Over-the-counter or prescription medication for pain management
Treatment Approach 2: Bunion Surgery
If the bunion is severe or getting worse, or if conservative care isn’t providing the relief you require, we then may move on to consider surgical intervention. We tend to see this as a last resort—we’d always prefer to exhaust conservative options first—but sometimes surgery is the best chance for you to regain a high quality of life without pain.
The surgical procedure will be determined based on factors including the severity of the condition, your age and health status, your lifestyle goals, and others. You may also wish to consider matters such as whether or not you have family or friends to help you during recovery, whether you can take time off from work or if you will be able to stay off your feet, and other concerns before selecting a date for surgery.
Specific procedures may include one or more of the following:
- Soft tissue repair of surrounding tendons and ligaments
- Removing the bony bump itself (exostectomy)
- Cutting and realigning bones (osteotomy) and holding in place with pins, screws, or other hardware
- Removing arthritic joint surfaces (arthrodesis)
- Entirely removing the damaged portion of the joint (resection arthroplasty), creating a “gap” of space around the joint that serves as a flexible “scar joint.” Usually only recommended in severe cases for elderly patients who have had unsuccessful surgery in the past.
As with any surgery, post-operative care and rehabilitation are of paramount importance in a successful recovery. Your surgeon will be sure to explain any instructions thoroughly, both before and after your surgery. Never be afraid to ask questions, or bring along a trusted friend or family member who can ask questions or take notes for you.
Getting the Best Bunion Care in Long Island
Dr. Corey Fox at Massapequa Podiatry Associates has helped thousands of patients just like you overcome their bunion pain, through a wide variety of both conservative and surgical techniques. Our mission is to listen carefully to what you have to say, understand your needs and goals, and help guide you toward your best possible treatment program. To set up an appointment, please call us at 516-541-9000.