Bunions

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe.  The big toe may turn in toward the second toe and the tissues surrounding the joint may be swollen and tender.  The symptoms of bunions include irritated skin around the bunion, pain when walking, joint redness and pain, and possible shift of the big toe toward the other toes.

Bunions are caused by a biomechanical abnormality, where certain tendons, ligaments, and supportive structures of the first metatarsal are no longer functioning correctly. This biomechanical abnormality may be caused by a variety of conditions intrinsic to the structure of the foot--such as flat feet, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although some experts are convinced that poor fitting footwear is the main cause of bunion formation, other sources concede only that footwear exacerbates the problem caused by the original genetic deformity.

Early treatments are aimed at easing the pain of bunions, but they won't reverse the deformity itself.  These options include:

• Changes in shoewear. Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition.
• Padding. Pads placed over the area of the bunion can help minimize pain. You can get special bunion pads from Dr. Prant.
• Activity modifications. Avoid activity that causes bunion pain, including standing for long periods of time.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve pain.
• Icing. Applying an ice pack several times a day helps reduce inflammation and pain.
• Injection therapy. Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located in a joint) sometimes seen with bunions.
• Orthotic devices. In many cases, custom orthotic devices, customized inserts, and shoe modifications done by Dr. Prant can be used. 

When a bunion interferes with daily living and early treatments aren’t enough, a variety of surgical procedures are available. The procedures are designed to remove the "bump" of bone, correct the changes in the bony structure of the foot, as well as correct soft tissue changes that may also have occurred. The goal of these corrections is the elimination of pain.

In selecting the procedure or combination of procedures for your particular case, Dr. Prant will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

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