What are Bunions?
Bunions are formed due to the misalignment and deformity of the metatarsophalangeal (MTP) joint at the base of the big toe, causing the first MTP bone to turn outward while the big toe turns inward. This leads to the joint at the base of the big toe to jut out prominently, an often unsightly and painful condition.
If left untreated and mismanaged, the bunion will worsen over time. This can lead to further pain and deformity of the other toes and foot.
Signs and Symptoms of Bunions
Bunions often happen in the hallux or the big toe. While mild cases may be almost unnoticeable, bunions tend to worsen significantly if left untreated, causing pain when walking.
Here are some of the symptoms of bunions:
- Redness of the big toe’s joint
- Bulging of the big toe’s joint
- Pain in the big toe’s joint
- Calluses caused by the friction of the hallux and the second toe (also known as the ‘long toe’ or ‘index toe’)
- Limits the movement of the big toe when moved
Causes of Bunions:
While the underlying cause is largely due to an inherited, bunion-prone structure of the feet; it is made worse with trauma and when feet are squeezed into ill-fitting shoes. This is why bunions affect women much more.
People working in jobs that require a lot of standing and walking (e.g. teachers, nurses) are also more susceptible to bunions.
The causes of bunions are classified into the following:
- Hereditary: There are several inherited foot structures that are more prone to bunions (e.g. low arches, loose joints, overpronation)
- Congenital foot conditions acquired since birth
- Rheumatoid Arthritis specifically on the foot
- Foot injuries such as sprain, fractures, and nerve injuries
- Shoes: A shoe’s size and shape can greatly affect bunions. For women, it has been shown that high heels and shoes with a narrow tip can cause bunions to become sore and swell, due to a large amount of pressure being exerted on the already misaligned joints in the big toe
Diagnosis of Bunions:
While bunions may start off mild and almost unnoticeable, they can worsen significantly if left untreated, leading to pain and swelling in the big toe’s joint. In such cases, its cause and severity must be identified in order to prescribe the most appropriate type of bunion treatment.
X-ray: An X-ray examination will help to identify the cause and severity of the bunion. This procedure allows the orthopaedic surgeon to evaluate if bunion surgery is required for the patient, or if conservative and non-invasive treatment will suffice.
Treatment for bunions differ depending on its severity, and in mild cases, there are some practical remedies that can be done at home. For instance, wearing wide shoes and flats can help prevent the worsening of bunions.
Treatments for bunions include:
- Ice Pack Treatment: This home remedy can alleviate the swelling of the bunions. Wrapping an ice pack on the affected area for 20 minutes can reduce the soreness caused by the bunion.
- Choose your shoes wisely: Shoes are a great factor in the prevention of bunions. Shoes that have wide spaces for the toes help relieve pressure in the affected areas.
- Medication: Medication such as over-the-counter painkillers can help alleviate the pain caused by bunions.
- Bunions Surgery: Bunion surgery, also known as hallux valgus correction, is the only way to effectively treat bunions if they are severe and do not respond to conservative treatment.
Common Types of Bunion Surgery:
- Osteotomy: The big toe joint is cut and realigned to a normal position
- Exostectomy: The bunion is removed from the big toe joint
- Arthrodesis: The damaged joint will be replaced with screws or metal plates to correct the deformity
The type of surgery used will depend on the individual’s condition. Usually, mild to moderate bunions can be treated by minimally invasive surgery with less pain and downtime, while severe bunions will require traditional open surgery.
Recovery Process after a Bunion Surgery:
Usually, patients are usually able to walk the same day of the bunion surgery, however, special post-operative shoes and straps must be worn in order to support the foot while it heals.
Once the bone and soft tissue heals, patients may also need to do physiotherapy to regain full mobility and walk properly again. Complete recovery can take 3-4 months.
Orthopaedic Surgeon Dr Sean Ng specializes in foot and ankle surgery, such as the treatment of bunions. Other than the correction of foot deformities, he is also especially interested in minimally invasive surgery of the foot, achieving maximal results with minimal pain and scarring. For that, Dr Ng is a member of the prestigious European Group for the Study and Research of Minimally Invasive Surgery of the Foot and Ankle (GRECMIP).
It is important to consult an Orthopaedic Surgeon to identify the causes and severity of bunions, as well as to determine if bunion surgery is needed or if conservative treatment will suffice. Contact Dr Sean Ng at 9631 7637 for a consultation today.
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