Bunions

What are they?

        Bunions are those unsightly enlargements or bumps that occur on the inside areas of your feet. A bunion deformity can cause a wide range of problems for the patient and consequently can involve a varied approach to o treatment. An important point to consider in the understanding of this problem is that it is a progressive deformity.  In other words, a bunion will in most cases worsen with time.  No one can predict how fast the deformity will progress or to what extent it will cause debility or symptoms but most authorities would agree that sooner or later, it will worsen.  Bunions, by nature, can cause pain in certain shoes, become a common site for arthritic changes, lead to secondary compensatory problems such as hammertoes or pain in the fat pad area.   They may cause serious aesthetic or shoe wear concerns for certain individuals especially women who have to wear higher styled type shoes.  Whatever the extent of involvement, a bunion deformity should warrant consideration by the patient and some level of professional evaluation by a foot specialist.

 What causes them?

         The possible causes of a bunion deformity are numerous and can only be numerically reduced pending a thorough examination by the foot specialist. Hereditary tendencies for bunions to occur in members of the same family, ranks high as a potential cause.   Another frequent culprit is that of our manner of walking and in what type of shoe we wear over the bunion.  In short, the particular mechanics of one’s walking style could be such that abnormal forces, pressures, and anatomical changes could result in a bunion deformity.  Various arthritic conditions such as osteoarthritis, rheumatoid arthritis and gout can also lead to deformities of the first metatarsal joint and a bunion. An important fact to keep in mind is that. Generally speaking, shoe can aggravate an existing bunion deformity but will not initially cause one to occur.

 How do you treat them?

         The treatment options for bunion deformities include a wide range of therapeutic approaches. An early approach might include shoe modifications, padding, physical therapy and occasional injection care for the existing symptoms.  Functional orthotics or foot supportive devices can, in many cases, reduce the involved abnormal forces and slow the progression of the bunion.  In short, this means that the orthotics might prevent the bunion from worsening and may even reduce any existing discomfort.  Surgical correction of the involved deformity is still another viable option and should be discussed thoroughly with your foot specialist.   There are three levels of bunion deformities and each require specific surgical approaches.  The bottom line is that a bunion deformity is not a condition to ignore or neglect.  A good clinical evaluation is a primary and highly recommended first line defense in the management of this condition.  For a more detailed article on bunions read Dr. Stern's  Article on Bunions.