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Bunions (Hallux Valgus)
A bunion is a “bump,” just behind the big toe, that projects inward or upward (Fig. 1). It is actually a deviation or dislocation of the joint behind the big toe (the first metatarsal phalangeal joint) (Fig 2). Certain forms of arthritis can also cause a bunion. Bunions are more painful in women because their shoes are less tolerant of the bump on the inner surface of the foot. Bunion pain is due to direct pressure by the shoe, arthritic changes in the joint, or overlying bursitis.
Bunions are hereditary. Improper shoes can aggravate bunions, but are not the cause of them. People with flat feet are more likely to develop bunions.
  
- Try shoes with a wide roomy toe box. Athletic running shoes and gym shoes are good examples.
- “Doughnut” shaped bunion shields, available at the pharmacy can reduce pressure on the bunion.
- Anti-inflammatory medicines like Advil and Aleve can reduce pain and calm down bursitis.
- Orthotics (special supports made by a podiatrist) can help certain types of bunions. Orthotics are most effective in children and teenagers, or when the bunion is mild.
If the bunion remains painful, it’s time to consider surgery.
If conservative treatment fails to resolve bunion pain, surgery is indicated to realign the first metatarsal phalangeal joint. Permanent correction of bunions can not be obtained by “cutting off the bunion.” Correction is accomplished by realigning the deviated joint (Fig. 3). Newer methods of bunion surgery use absorbable pins and screws to hold the bones in place while they heal. The surgery is performed on an outpatient basis under local anesthesia with sedation.
If you have questions or would like to discuss the treatment on Bunions (Hallux Valgus), please contact The
North Shore Podiatry Group.
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