A bunion is a bone deformity which occurs at the base of the
big toe involving a joint called the metatarsophalangeal joint.
The enlargement of bone at the base of the big toe often rubs
against shoe wear causing excessive pressure and friction
resulting in discomfort. The great toe angles out toward the
other toes. This condition is known as Hallux Valgus. Overtime
as the bunion enlarges the big toe may overlap or move under
the adjacent toe. As the bunion enlarges and the big toe moves
toward the other toes, a hammertoe may develop in one or more
of the other toes.
cause discomfort along the side of the great toe due to the
enlargement of rubbing against shoes with everyday walking.
Since the great toe joint moves with every step. There may
also be pain from within the joint (the metatarsophalangeal
joint) and formation of arthritis. The soft tissue along the
side of the big toe joint may also enlarge causing a condition
called bursitis. The skin on the bottom of the foot or along
the side may become thickened with callous formation as a
result of friction and excessive pressure from the bunion.
notice that bunions run in the family however they are not
hereditary. Although bunions are not inherited, it is possible
to inherit a faulty foot structure which often leads to bunion
formation. Although footwear may not be a direct cause of
bunions, certain types of shoes such as high heels or very
narrow dress shoes promote the formation of bunions. The shape
of the shoe forces the front of the foot into an unnatural
angle. Maintaining the foot in this position for long periods
of time can cause the toes to permanently change position
and result in the formation of a bunion. Arthritis can also
alter the position of the joint leading to formation of a
are a bone deformity, they do not resolve themselves. Conservative
or nonsurgical treatment is mainly focused on relieving pressure
over the affected area and stopping the progression of the
commonly used to relieve pain and pressure from bunions include:
Change in footwear to more accommodative shoes which do
not cause excessive friction or promote the progression
of the bunion. Avoid high heel shoes.
Have your shoes spot stretched over the bunion
Orthotic devices to help realign and maintain correct foot
position during standing and walking.
Removal of corns and calluses which form on the foot.
Use of protective padding to help reduce or eliminate friction
against the shoe.
Splints worn during the night to help align the big toe
joint. In younger patients such as adolescents this may
be recommended because their bones are more adaptable as
they are still developing.
A spacer pad may be placed between the big toe and second
Avoid activities that cause irritation over the bunion
- Consider the
use of anti-inflammatory medications to reduce inflammation
(provided you do not have any contraindications to the use
of such medications)
custom made orthotics to address abnormal foot mechanics
cortisone injections if there is bursitis over the bunion
measures do not adequately relieve symptoms and stop progression
of the deformity and related conditions surgical treatment
may be advised. Surgery for a bunion, called a bunionectomy
involves removal of the enlargement and realignment of the
If conservative measures do not adequately relieve symptoms
and stop progression of the deformity and related conditions
surgical treatment may be advised. Surgery for a bunion, called
a bunionectomy involves removal of the enlargement and realignment
of the toe. Since bunions comein different sizes and shapes,
there are different methods used to treat different types
and sizes of bunions. Although there have been several different
bunion procedures performed and named over the years, they
are generally divided into two categories:
- Metatarsal head procedures performed close to the big toe
joint. This type of procedure is used to treat mild to moderate
Metatarsal base procedures performed further
away from the big toe at the base of the metatarsal bone.
This type of procedure is used to treat moderate to large
In both of the procedures listed above, a specialized bone
screw, pin or combination is typically used to maintain the
bone in corrected position while it heals.
When selecting the bunion surgery that is best for you the
following should be considered:
Overall medical condition
Severity of bunion deformity
How long does it take to heal after bunion surgery?
If bone was repositioned and fixated as part of the procedure,
healing time is 6 to 8 weeks on average. Once the bone has
healed, you are encouraged to gradually return to normal activity
as tolerated. Some amount of swelling may last longer than
the bone healing time therefore when turning to regular foot
wear, it is advised to avoid shoes that are too tight. Over
the months following bunion surgery, the swelling will progressively