If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion. More than half the women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes, and high heels. Bunions may occur in families, but many are from wearing tight shoes. Nine out of ten bunions happen to women.
Nine out of ten women wear shoes that are too small. Too-tight shoes can also cause other disabling foot problems like corns, calluses and hammertoes. Bunions are also caused by hereditary factors. Flat feet, loose ligaments and tendons are major contributing factors as well.
With a bunion, the base of your big toe gets larger and sticks out. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. An advanced bunion may make your foot look grotesque. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.
Relief from bunions
Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, never force your foot into a shoe that doesn’t fit. Choose shoes that conform to the shape of your feet. Go for shoes with wide insteps, broad toes and soft soles. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 2 1/4 inches. If you already have a bunion, wear shoes that are roomy enough to not put pressure on it. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You may also try protective pads to cushion the painful area.
If your bunion has progressed to the point where you have difficulty walking, or experience pain despite accommodative shoes, you may need surgery. Bunion surgery realigns bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Dr. Morelli has several techniques to ease your pain. Many bunion surgeries are done on a same-day basis (no hospital stay) using local anesthesia and IV sedation. Complete recovery may take 4 to 6 weeks for many types of surgical procedures, but you are usually able to walk soon after the procedure and are encouraged to do so.
Adolescent Bunion aka: Juvenile Hallux Abducto Valgus Deformity
Your young teenager (especially girls aged 10-15) may develop an adolescent bunion at the base of the big toe. Unlike adults with bunions, a young person can normally move the affected joint. Your teenager may have pain and trouble wearing shoes. Try having your child’s shoes stretched and/or getting wider shoes. Orthotics are also encouraged in an effort to control your child’s foot and reduce their pain. Surgery to remove this type of bunion is not recommended unless your child is in extreme pain and the problem does not get better with changes in shoe gear and orthotics. If your child needs bunion surgery, specific surgical procedures are chosen so that their bone growth is not affected.
Bunionette aka: Tailors Bunion
If you have a painful swollen lump on the outside of your foot near the base of your little toe, it may be a bunion as well. You may also have a hard corn and painful bursitis in the same spot and the little toe may also be affected. Wearing shoes that are too tight may cause it and aggravate it. Get shoes that fit comfortably with a soft upper and a roomy toe box. In cases of persistent pain or severe deformity, surgical correction is also possible.
Dr. Morelli is a board certified foot surgeon with extensive training in the diagnosis and non-surgical and surgical treatment of the foot, including bones, joints, ligaments, tendons, muscles and nerves.
Dr. Charles Morelli is a Board Certified Foot Surgeon and is certified by the American Board of Podiatric Surgery. This certification increases the standards and criteria a specialist must meet in order to be considered competent. Dr. Morelli has achieved the highest level of professionalism for Podiatric Board Certification. He has successfully passed the required National Board Exam and has completed a special credentialing process to validate recognition by insurance companies and hospitals. His podiatric privileges include medical and surgical foot management and the treatment of disease, deformities, and trauma.
Bunion Surgery
Types of Bunion Surgery
Podiatric surgeons use many different surgical procedures to treat bunions. The common goal of these procedures is to realign the joint, relieve pain, and correct deformity. These procedures include:
Repair of the Tendons and Ligaments Around the Big Toe
These tissues may be too tight on one side and too loose on the other, creating an imbalance that causes the big toe to drift toward the others. Often combined with an osteotomy (cutting of the bone), this procedure shortens the loose tissues and lengthens the tight ones.
Arthrodesis (Joint Fusion) Removal of the damaged joint surfaces, followed by the insertion of screws, wires, or plates to hold the surfaces together until it heals. Used for patients with severe bunions, severe arthritis, and when other procedures have failed.
Exostectomy Removal of the bump on the toe joint; used only for an enlargement of the bone with no drifting of the big toe. This procedure is seldom used because it rarely corrects the cause of the bunion. It is reserved for patients who suffer from “bump pain” and when there is a small deformity.
Resection Arthroplasty Removal of the damaged portion of the joint, (a.k.a., Keller Arthroplasty) used mainly for patients who are older, have had previous bunion surgery, or have severe arthritis. This creates a flexible "scar" joint.
Dr. Charles Morelli is a Board Certified Foot Surgeon and is certified by the American Board of Podiatric Surgery. This certification increases the standards and criteria a specialist must meet in order to be considered competent. Dr. Morelli has achieved the highest level of professionalism for Podiatric Board Certification. He has successfully passed the required National Board Exam and has completed a special credentialing process to validate recognition by insurance companies and hospitals. His podiatric privileges include medical and surgical foot management and the treatment of disease, deformities, and trauma.
