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Bunions

Your big toe is constantly at work when you walk. Every time your foot pushes off the ground, this toe supports most of your body's weight. Because the big toe is so critical to movement, any problem with it can make walking or even standing painful. A bunion is one of the most common big toe problems. In addition to causing pain, a bunion changes the shape of your foot, making it harder to find shoes that fit. It also alters the way you walk and can cause pain to other areas of the foot. But you do not have to hobble for the rest of your life. Bunions can be treated, and with your doctor's help, your feet can feel and look better.

Causes:
Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics and very commonly from family inheritance. In some cases, joint damage caused by arthritis or an injury produces a bunion. Some people are simply born with extra bone near a toe joint. If you are at risk for developing a bunion, wearing high-heeled or ill-fitting shoes can make the problem worse.

Treatment:
If a bunion is not severe, your doctor may recommend that you wear a different style of shoes. Custom-made shoe inserts (orthotic devices) may be prescribed to control incorrect foot mechanics.

For severe bunions, outpatient surgery may be recommended. Within hours after surgery, you will be on your way home, and ready for recovery. To realign the affected joint, any tight tendons on the inside of the toe are released. Some of the bone that makes up the bunion is shaved away.

The most common bunion surgery reduces the angle between the first and second toes. Bones in the big toe are realigned, and the bunion is shaved away. Ligaments and tendons on the outside of the toe may be tightened to hold the joint properly for a more permanent correction.

If a bunion is severe, a piece of bone is removed from the first metatarsal (the long bone behind the big toe joint). Once repositioned, this bone may be held in place with a pin or a screw. Any new bone that makes up a bunion is shaved away.

Bunion surgery can reduce pain and improve the appearance of your feet. For best results, see your physician as scheduled, and follow all recovery instructions. Your foot will be bandaged after surgery. If soft tissues were shifted, you may be given a splint to limit foot movement for a while. In such cases, the majority of healing should occur within a few weeks. If bone was cut, you may need to wear a surgical shoe, or your foot may be placed in a cast. Depending on the extent of the repair, healing may take a few weeks to several months. The longer a patient waits to have a bunion repaired the more involved the repair may be.

*photo credit: The StayWell Company / Krames Patient Education