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Bunions: ‘Bumps’ on Your Feet

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Do You Need Surgery for Bunions

bunionsBunions are one of those small irritations that appear, uninvited, in late middle age.

These ‘bumps’ on your feet, which may make wearing shoes painful, are actually composed of joint tissue that’s growing the wrong way.

Some research suggests that wearing certain types of footwear, such as high heels or tight-fitting shoes, might make a person susceptible to bunions. It’s true that bunions are common in ballet dancers.

In fact, 88% of American women wear shoes that are too small, according to a study conducted by the American Orthopaedic Foot and Ankle Society. And more than half of women have bunions.

Bunions touching on a pair of human feet

For most patients, conservative treatment can reduce irritation.

If the bunion has gotten to the point where it hurts to walk or stand for any length of time, your doctor may advise surgery.

If you’re reading this, it probably doesn’t matter how the bunions came to be. You just want relief.

 

But first we need to make sure that what you have is actually a bunion. Because gout and arthritis can also cause swelling and foot pain, the doctor will perform an examination to diagnose the problem.

Foot Examination


A foot examination might include an assessment of the anatomy as well as having you perform certain movements.

X-rays might be ordered to enable the doctor to analyze the bone structure in your foot, the integrity of the joints and the alignment of the toes.

If Doctor decides that your condition is a bunion, then it’s time to talk about treatment options.


Bunion Treatment Options

Alternative Treatment

The conservative treatment is rest, custom-fitted shoes (orthotics) and anti-inflammatory medication such as ibuprofen or aspirin. If the skin is broken or there appears to be an infection, antibiotics might be called for. Stretching exercises sometimes help. We could also try an injection of cortisone to help speed the body’s healing processes.

In cases where the bunion refuses to respond to conservative therapy, surgery is an option. Doctor may advise a bunionectomy, which is an operation to remove some of the growth that’s causing the problem and re-align the toes.

Bunion Surgery

While surgery is not the first recommendation for most patients, 85 to 90% of patients who have had bunion surgery report dramatic relief of pain and re-alignment of the big toe for a more comfortable gait.

The goal of bunion surgery is not to reshape the foot into a perfect mold. The goals are to relieve pain and correct the deformity so that bunions will not cause future problems. Your surgeon may also repair the tendons and ligaments around the big toe, to ensure more support. In severe cases, we may remove the joint surface and implant a wire or plate to hold the bone in place while it is healing. We can also remove the damaged joint altogether.

bunions surgery before after

Post-surgical patients should guard against developing another bunion. Often the original problem was caused by biomechanics— i.e., the gait or physiology of a person’s foot. If the patient resumes wearing shoes that cause a problem and nothing has changed biomechanically, the bunion could reappear. This is discouraging for patients who’ve traveled the long road from diagnosis to conservative treatment to surgery to rehab— only to be told they should start at the beginning again.


Bunionectomy

Bunionectomy can be performed in our clinic. The patient receives local anesthesia, and remains conscious throughout the surgery. Within a few hours, the patient is ready to go home. You’ll be fitted with crutches, a cane or a walker to keep the weight off your foot until it heals. Gradually, you will start putting weight on the foot. You should be able to drive or walk short distances within a week.


Bunions Are Major Cause Of Aching Feet

At our clinics in DeSoto, Dallas or Sunnyvale, we see many patients with bunions in various stages of development. Very often, a patient’s biomechanics are a factor. Overpronation, for instance, when the foot rolls outward as you walk, has been associated with bunions, hammer toe and crossover toe.

While shoes are not the direct cause of a bunion, some footwear can increase discomfort. Tight shoes, narrow toe box, high heels … all have been linked to increasing the pain and disability associated with bunions. Bunions are common in ballet dancers, whose work entails standing en pointe in tight-fitting shoes. (At the clinic, we recommend supportive footwear with arch support, exercising the mid-foot, and taping and padding the inside of the shoe to keep ballet dancers’ toes aligned.)

By the way, women are more apt to be afflicted with bunions— ten times as frequently as men.

Some patients, especially younger people who develop bunions, may have a hereditary disposition. An abnormal shape of the foot or arthritic disease such as rheumatoid arthritis can lead to bunions.

If you feel you’ve lived long enough with the pain and inconvenience of a bunion, call our clinic [phone] and let’s discuss your options. The great majority of patients are satisfied with the results of bunion surgery.

Let’s see what we can do for you.

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