Should a bunion be treated surgically or not?
A bunion is a bump at the base of the big toe where it attaches to the foot, which is caused by the big toe pointing in toward the next toe and pushing the joint out. Because a bunion occurs at a joint, where the toe bends in normal walking, the entire body weight shifts because of the bunion. This causes excess pressure and friction from shoes that can lead to the development of calluses.
For many people, bunions can be hereditary and may be just one of several problems due to weak or misaligned foot structure. Bunions sometimes develop along with arthritis.
Bunions are quite painful and often look unappealing – however they may not necessarily require surgery (even if you want to wear high-heels). Surgery should only be considered if an adequate course of non-operative care has failed to help. Simply telling a patient to wear wide shoes and avoid heels is not an adequate treatment plan all of the time; however, sometimes this simple treatment works.
In order to properly treat a bunion and decide if surgery is needed, your doctor must do a thorough analysis of your foot’s anatomy along with the rest of the linkage of the leg. In addition, your activity level and work should be considered. Finally, any problems like diabetes or osteoporosis must be considered. Surgery works well most times, but not every time and should never be selected lightly.
Your foot doctor or surgeon will evaluate the bunion and decide what treatments will work, as there are a number of non-operative options available.
Mild bunions that are not too painful can be treated with:
- Pads
- pain creams
- shoe modifications
- night splinting – splints worn at night can often prevent the bunion’s rapid progression
Severe bunions may require:
- splints for use at night and during the day
- pain creams
- massage
- reflexology
- surgery
If the bunion is so severe that the toes are crossing over each other, surgery is usually considered.
Although it may not seem logical, physical therapy can help with a bunion as well. A bunion is simply the presenting component of a complicated biomechanical foot and ankle problem. The entire foot and ankle must be considered to properly treat the problem. Physical therapy can address the muscular constrictions, tendon contractures and joint abnormalities that all contribute to the bunion and make it painful.
After a good course of therapy, a patient’s foot will hopefully become flexible and strong enough that the bunion stops hurting.
Image courtesy of zirconicusso / FreeDigitalPhotos.net
Dr. Meredith Warner is a board certified, Fellowship Trained Foot and Ankle, Orthopedic surgeon practicing in Baton Rouge, Louisiana. Dr. Warner is committed to offering her patients an accurate diagnosis along with a comprehensive treatment plan in order to get them back to a pain free life. Dr. Meredith Warner specializes in the treatment of orthopedic issues, providing operative and non-operative treatment plans of orthopedic problems, including musculoskeletal pain such as chronic back, neck and foot pain, reconstructive surgery of the foot and ankle, arthritis, diabetic, hammer toe, bunion, wound care, work injuries, fitness and nutrition and osteoporosis issues.
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