| Charles E. Hammonds, D.P.M.
Well, it has finally happened. That ugly, angry, big toe deformity
that made your mother hide her bare feet and limp around has suddenly appeared
on your foot...and it hurts. Your formerly stylish pumps are stretching
to accommodate the bump and area barely wearable. You never thought
it would happen, but the idea of walking through a shopping mall sounds
more like torture than fun.
Chances are, you have a bunion. The bone in the joint at the base
of the big toe is enlarging and causing discomfort by rubbing against your
shoes. By the end of the day, there’s a deep, aching pain in that
joint and all you want to do is sit down and take your shoes off.
Contrary to popular opinion, bunions aren’t caused by ill-fitting shoes;
footwear may aggravate them, but the don’t cause them. Bunions are
often hereditary and develop from a weakness in the foot’s bone structure.
All the bones and ligaments which make up the foot’s arches and joints
are very mobile and flexible. When the move out of alignment due
to faulty foot function, the big toe joint is overloaded, causing it to
unlock and dislocate. This doesn’t happen all at once. Bunions
develop gradually but continuously, and can cause pain at various levels
of enlargement.
With bunions, the best defense is a good offense. In the early
stages, there are a variety of effective treatments. If left undiagnosed
and untreated until the bunion is in an advanced stage, a significantly
more serious deformity must be addressed, and that can mean more discomfort
and loss of mobility.
Treatment begins with isolating the cause of the problem so that some
of the more uncomfortable symptoms do not develop. Early intervention
can involve exercise, modification of foot wear, and prescription orthotics
aimed at stabilizing any structural weakness in the foot. The emphasis
at this stage is on managing the problem by keeping it from getting worse.
Anti-inflammatory medication can also help during acute episodes of bunion
pain.
| There are also various surgical methods to correct a bunion deformity.
Obviously, the less deformity there is to correct, the better the surgical
outcome. That doesn’t mean that surgery should be the first course
of action; it is not. Again, early diagnosis -- based on a thorough
examination and X-rays -- made by an experienced podiatrist, can determine
which course of treatment will be the most effective.
There are some bunions that ultimately require surgery. This is
a pain-based decision, when the sufferer notices significant changes in
the position of the big toe or when they begin altering their walking style
to favor the bunion joint. When a bunion bothers you during reasonable
daily activity, while wearing reasonable footwear, it may be time to consider
a surgical remedy. |
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As with any surgery, it is important to select the right procedure and
to rigorously adhere to the podiatrist’s specific recommendations for follow-up
care. There have been remarkable advances in foot surgeries and treatment
options during the past decade, but there is still no magic wand to make
bunions -- or the pain they can cause -- disappear overnight.
There are three basic objectives of bunion surgery: to relieve pain,
to correct structural abnormalities, and to restore function. In
the final analysis, recovery and outcomes are better if these are the reasons
bunion surgery is performed. |
