What is a Bunion?
Commonly known as a bunion, hallux valgus affects the joint at the base of the big toe and is known as the bump that grows on the side of the metatarsophalangeal joint (or MTP joint). However, this condition is more severe than a simple bump on the side of a big toe due to the severe pain it can cause and the disfigurement that can occur if not treated properly. This foot / toe condition be treated by our San Jose podiatrist Dr. Nguyen Ky DPM.
Normally found in cultures where shoes are worn, especially with people who wear pointed toed shoes (high heels and cowboy boots), hallux valgus can be sidestepped by wearing shoes that are wide and have room for the toes to spread out. If someone already has a bunion, switching to a wider shoe can decrease irritation and help lessen the chance of a small bump becoming a deformity that is a severe problem.
Anatomy of the Foot
What happens to the big toe is actually what hallux valgus means. In Latin, hallux means ‘big toe’ and valgus means “a deformity involving oblique displacement of part of a limb away from the midline”. Together, the words basically mean that the big toe is beginning to point toward the outside of the foot. As hallux valgus worsens, other changes will occur that will make the problem more severe and painful.
What Causes a Bunion
Many things can occur that will cause a bunion, such as an abnormal pressure or rubbing against the toes. A simple way to see the effects of abnormal pressure to to simply view the foot. Most of the symptoms that occur over time will show on the skin due to the soft tissue and bone rubbing hard against the shoe.
Any bump in the bone, no matter the size, will make things worse. the top skin will respond to this constant contact by forming a callus while the soft tissue underneath will grow thicker. In order to decrease the pain that will be caused by this, one simply must remove what is causing this pressure. The simplest way to remove the pressure is to change the types of shoes being worn, but the most effective way to get rid of the pain is by undergoing surgery to remove any notable bony structures that may be causing the pain.
Symptoms of Hallux Valgus or Bunions
Hallux Valgus can normally be found at the center of the bunion, which will be painful. Not only a distressing pain for many people, it is also a severe cosmetic deformity. Finding comfortable shoes is extraordinarily difficult, especially for women who have jobs that require fashionable footwear. This deformity will also cause the second toe to become displaced, and will cause the toe to constantly rub against the shoes being worn.
Diagnosing Bunions / Hallux Valgus
A careful examination and look into a patient’s’ history by a physician will bring a diagnosis for this condition to light. During this appointment, a heavy discussion of footwear will take place, and x-rays will be recommended to see how severe the condition is. This condition can also affect childrens’ feet.
Bunions / Hallux Valgus Treatments Available
- Nonsurgical: Most cases of Hallux Valgus begin with changing footwear. If caught in the early stages, changing from a pointed toe to a wide toe may stop the progress of the affliction. The first problem that is being faced is the pain problem from the bunion, which is why it is important to focus on releasing the pressure that the shoe places on the foot.
- Surgical: If nonsurgical measures are not enough to control the problem, surgery may be an alternative to treat the problem. There are more than 100 procedures that exist to treat this condition, and there are a few factors that need to be considered before a surgery may take place.
In some cases, Bunion surgery, or bunionectomy may be considered to remove the bump that makes the bunion. Bunion surgery is performed via a small incision on the side of the foot that is over the area of the area. In some cases, a realignment of the big toe will be needed as well, and this decision impacts if the second metatarsal bone will be cut and realigned or not. If it is angled at over 13 degrees, it will most likely need to be realigned due to the normal angle being between nine or ten degrees.
In other cases, the far end of the bone is cut and moved laterally in a surgery called distal osteotomy, which reduces the angle between the first and second metatarsal bones. Another surgery that may take place could be a proximal osteotomy, which is done when the first metatarsal is cut near the end of the bone.
Rehabilitating After Treatment
If nonsurgical treatment was done, rehabilitating will include four to six physical therapy sessions due to painful bunions. A therapist may offer ideas for shoes that have a wide toe box, which will provide spacious room for the toes so that the metatarsals will not be squeezed when inside a shoe. There is also a special pad that can be placed over the bunion when wearing shoes.
If surgery has been done, it will take around eight weeks for the bones and soft tissues to be healed. A wooden-soled shoe or cast may be needed to be worn during this time to help protect the bones as they go through the healing process. Crutches may also be needed, and a physical therapist may be consulted to help with their use.