Bunions are among the most common foot problems in the field of podiatry. At our Boynton Beach, Florida office, a large segment of the patients we treat have some sort of bunion formation. Bunions affect billions (yes, with a B) of people worldwide, causing foot pain and deformities that affect everything from the look of the feet to the way a person walks. Bunions can cause pain and other foot issues, so addressing bunions once they begin to form is a meaningful step in the prevention of further issues. But first, let’s talk about what bunions are and how they are formed.
What are Bunions?
Foot bunions, also known as Hallus Vagus, is the displacement of bone or tissue at the big toe joint. Although, smaller “Bunionettes” can also form on the little toe joint, on the opposing side of the foot. Bunions are one of only a few foot issues that can happen both naturally – through a person’s genetic profile – or can happen as a result of environmental factors – most notably from ill-fitting footwear. In fact, Bunions are among the most common foot issues because they can happen naturally and environmentally.
How do you get Bunions?
Bunions can form genetically (due to the shape of the foot and/or gait), as a result of arthritis, or due to binding footwear. Those with stiff joints or arthritis may experience more pain along with bunion formation than those with more flexible joints. A person’s unique biomechanics and gait can cause hypermobility of the first ray, thus causing deviation of the big to and a bony prominence
It is believed that women have a higher likelihood of developing bunions simply as a result of their preferred choice of shoes. High heeled shoes push the foot toward to the, causing pressure and crowding in the toe area of the shoe. In addition, narrowly-designed shoes that are angled to compress the toes inward can also lead to the formation of bunions. High-heeled shoes with a compressed forefront area compound the probability that you will experience foot pain, pressure, and the possibly of the formation of bunions.
Bunions can also lead to Hammertoes, Bursitis, or pain in the ball of the foot (Metatarsalgia). This happens as the big toe pushes inward, affecting the alignment of the other toes. In addition, the big toe is a critical component to the overall human physiology. The big toe is responsible for balance, bearing weight and “pushing off” during walking. Try to walk without your big toe and see how it affects your gait, balance, and dexterity! In short, bunions can affect a person’s entire physiology, leading to pain and misalignment throughout the body if left unresolved.
How can you remove Bunions?
The only way to permanently fix and remove a bunion is with surgery. However, you can prevent more severe bunion problems by diagnosing the issue early and changing to roomier, more comfortable footwear. We offer in-office x-rays and diagnostic tools at both of our Boynton Beach, Florida offices. However, there are no therapeutics or medications that can diminish the size of a foot bunion or remove it completely. Rather, temporary relief is possible with custom foot orthotics, cushioned pads to alleviate pressure and pain, and icing the area if it has become inflamed.
Here are some of the most common bunion surgeries we perform at our Palm Beach County surgical center:
An Osteotomy realigns the big toe joint, muscles, tendons, and ligaments. This surgery targets the metatarsal bone and improves the alignment with plates, screws and/or pins. The exact surgical needs depend on each patients unique bunion structure.
An Exostectomy removes the bunion only without performing a realignment. Either soft tissue can be removed, or the bone can be shaved down.
Arthrodesis is performed when arthritis is present – which causes the degeneration of the big toe joint. This surgery replaces the joint with screws or metal plates. The joint can also be replaced similarly to the way a hip replacement restores the mobility of the hip: with an artificial joint mechanism.
Implant arthroplasty of the first metatarsophalangeal joints is another option to completely fusing the toe. This surgical procedure alters or completely replaces the joint. There are different levels of arthroplasty, including resection arthroplasty, interpositional arthroplasty or total joint arthroplasty. The goal of this surgery is to remove damaged portions of the toe joint and replace with artificial components to restore mobility and eliminate pain.
The remaining, common bunion surgeries are often a balance of different strategies that pull from these main types. The type and depth of surgery to correct a bunion is completely dependent on the person’s unique condition, and includes many factors such as age, level of degeneration, level of activity, presentation of underlying disease, and lifestyle.