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Bunion Deformity

What is a Bunion?

PAINFUL BUNION  CONDITION

A bunion is a bony bump that forms on the joint where your big toe meets your foot — called the metatarsophalangeal (MTP) joint. It happens slowly over time, and eventually gets bigger and sticks out. It can make your big toe turn in, sometimes so far that it moves on top of the toe next to it.

What Causes A Bunion? 

The classic bunion, medically known as hallux abductovalgus or HAV, is a bump on the side of the great toe joint. This bump represents an actual deviation of the 1st metatarsal and often an overgrowth of bone on the metatarsal head. In addition, there is also deviation of the great toe toward the second toe. In severe cases, the great toe can either lie above or below the second toe. Shoes are often blamed for creating these problems. This, however, is inaccurate. It has been noted that primitive tribes where going barefoot is the norm will also develop bunions. Bunions develop from abnormal foot structure and mechanics (e.g. excessive pronation), which place an undue load on the 1st metatarsal. This leads to stretching of supporting soft tissue structures such as joint capsules and ligaments with the end result being gradual deviation of the 1st metatarsal. As the deformity increases, there is an abnormal pull of certain tendons, which leads to the drifting of the great toe toward the 2nd toe. At this stage, there is also adaptation of the joint itself that occurs.

Bunion Symptoms

  • A bulging bump on the outside of the base of your big toe
  • Swelling, redness or soreness around your big toe joint
  • Corns or calluses — these often develop where the first and second toes rub against each other
  • Ongoing pain or pain that comes and goes
  • Limited movement of your big toe

The most common symptoms associated with this condition are pain on the side of the foot. Shoes will typically aggravate bunions. Stiff leather shoes or shoes with a tapered toe boxare the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other. On rare occasions, the joint itself can be acutely inflamed from the development of a sack of fluid over the bunion called a bursa. This is designed to protect and cushion the bone. However, it can become acutely inflamed, a condition referred to as bursitis.

Bunion Deformity Treatment

Early treatment of bunions is centered on providing symptomatic relief. Switching to a shoe with a rounder, deeper toe box and made of a softer more pliable leather will often provide immediate relief. The use of pads and cushions to reduce the pressure over the bone can also be helpful for mild bunion deformities. Functional foot orthotics, by controlling abnormal pronation, reduces the deforming forces leading to bunions in the first place. These may help reduce pain in mild bunion deformities and slow the progression of the deformity. When these conservative measures fail to provide adequate relief, surgical correction is indicated. The choice of surgical procedures (bunionectomy) is based on a biomechanical and radiographic examination of the foot. Because there is actual bone displacement and joint adaptation, most successful bunionectomies require cutting and realigning the 1st metatarsal (an osteotomy). Simply “shaving the bump” is often inadequate in providing long-term relief of symptoms and in some cases can actually cause the bunion to progress faster. The most common procedure performed for the correction of bunions is the 1st metatarsal neck osteotomy, near the level of the joint. This refers to the anatomical site on the 1st metatarsal where the actual bone cut is made. Other procedures are performed in the shaft of the metatarsal bone and still, other procedures are selected by the surgeon that are performed in the base of the metatarsal bone (see surgeries performed in the base of the metatarsal)

Our Board Certified Podiatrists

Socal Foot and Ankle doctors are committed to delivering the most exceptional treatments.

Image of Dr. Arash Hassid,DPM, Socal Foot Ankle Doctors, Podiatrist Los Angeles
Arash R. Hassid, DPM

Board Certified Foot & Ankle Specialist

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Image of doctor Daniel L. Altchuler, DPM , Socal Foot Ankle Doctors
Daniel L. Altchuler, DPM

Board Certified Foot & Ankle Specialist

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Location: Santa Monica

Mon – Thur: 9:00 AM – 5:00 PM

Friday: 9:00 AM – 5:00 PM

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