A bunion is generally considered an enlargement of the joint (a lump of bone) at the base and side of the big toe (specifically, the first metatarsal-phalangeal joint). Bunions form when the toe moves out of place. As the big toe bends towards the others this lump becomes larger and the bunion can become painful – arthritis and stiffness can eventually develop.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Bunions can be treated with wider shoes, pads, splints and orthosis. These all help to reduce the symptoms but they don’t “get rid” of the condition. Since bunions are a bone deformity, they do not resolve by themselves. The goal for bunion treatment is to relieve the pressure and pain caused by irritations and, second, to stop any progressive growth of the enlargement.
Bunion surgery is performed when conservative measures have been exhausted and pain persists. The surgery is performed on an outpatient basis. An incision is placed over the first metatarsal bone. Once the bone is exposed, the bump is removed. An osteotomy is performed in order to move the bone inward towards the second metatarsal. Pins, screws or other hardware can be used to stabilize the osteotomy.
Recovery for bunion surgery is approximately six to eight weeks. Often times you are able to walk immediately following surgery. Walking is done in protective shoes or boots with or without use of crutches. Physical therapy is used to increase mobility after surgery.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet and pronated feet can contribute to their formation.