Keeping It Real: The Truth About Bunions

Dr. Fox
Ira M. Fox, D.P.M.

A bunion is the bump on the inside of the big toe.  The complete picture is more complex.  The 1st metatarsal drifts inwards causing the big toe to drift towards the small toe.  There is an increasing space between the 1st and 2nd metatarsal (metatarsus primus varus).  The big toe can rotate (hallux valgus) .

A bunion deformity is a progressive problem.  The longer it exists, the more the great toe moves toward the second toe and the larger the bump becomes.  The earlier the onset, the worse the ultimate deformity.

MYTHS about bunions

  • Bunions are caused by tight shoes
  • Bunion splints work
  • Bunions can be fixed using laser (or as I call it the magic wand)

TRUTHS about bunions

  • The predilection for bunions is hereditary.
  • Bunion splints do not work
  • Bunions cannot be fixed using a laser or a magic wand
  • Cutting off the bump alone will not solve the problem long term

Associated problems

  • As the big toe drifts towards the small toes……
  • The second toe dislocates at the metarso-phalangeal joint
  • The big toe goes under the 2nd toe
  • The 2nd metatarsal gets pressed downwards, leading to calluses on the bottom of the foot

Conservative treatments
There are no exercises, splints or other devices that reliably correct a bunion.  Orthotics can sometimes slow or halt the progression of a bunion.  Pads, cortisone injections and changes in shoes may offer symptomatic relief.

Surgical Treatments
When the pain of a bunion interferes with daily activities, it’s time to discuss surgical options. When you are in enough pain that you are willing to put up with the inconvenience of the post-operative period, it’s time for surgery.

Goals of Surgery
The goals of surgery are to reduce space between 1st and 2nd metatarsals, straighten big toe, eliminate the bump & reduce or eliminate pain.

A variety of surgical procedures are performed to treat bunions. The procedures are designed to remove the “bump” of bone, correct the changes in the bony structure of the foot, as well as correct soft tissue changes that may also have occurred.  In selecting the procedure or combination of procedures for your particular case, the surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
As with most surgical procedures maximal medical improvement following bunion surgery takes 12-18 months!

Just remember, surgery  can make your foot better, not perfect. The time to do the surgery is when you are prepared for the post-op inconvenience. No magic wand treatment is available.  For more information visit our website: http://www.shoreorthodocs.com or to schedule a consultation please call 609.927.1991 

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