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Life in Motion

The “bump” even a nice pedicure can’t hide

Medical Science

Bunions: Causes and Treatment Options

With summer in full swing, you may find yourself paying more attention to your feet.   For some it is fighting dry skin, for many it’s keeping up with your pedicure, and for others it is an enlargement of the base of your big toe.  This enlargement is a bunion – one of the most common foot problems among Americans. The bump is a result of a dislocation of the big toe joint that results in the 1st metatarsal bone’s “head” becoming prominent.

We asked New England Baptist orthopedic surgeon Christopher Miller, MD  and specialist in minimally invasive foot and ankle surgery  what causes bunions and different treatment options.

What causes bunions?

Bunions often run in families and can be hereditary, but most commonly it is due to years of modern shoes and fashion styles which constrict the forefoot and push the toes together. High heel shoes have also been a suspected culprit. This is likely why bunions are much more common in women. The important thing to realize is that a bunion is not an abnormal bone growth. The bones are normal, but they are in the wrong position. As the bones shift position in the foot, the ligaments and soft tissues will make the deformity worse over time. While shoes and genetics play a role in starting the bunion, it is ultimately the soft tissue imbalance that accentuates the problem.

Do all bunions require surgery?

In general, if your bunion is not painful, you do not need surgery. Although bunions may get larger over time, surgery is rarely recommended to prevent bunions from worsening. If you are able, you can try to wear shoes with more room to prevent irritation to the bump.  Many patients can adjust to their bunion with simple shoe modifications, braces, or toe spacers. Surgery is considered when the bunion is painful or limiting your activities in some way.

What are my surgery options?

Traditional bunion surgery typically requires a several month period of limited activity and large incisions. You may know someone who has had bunion surgery and felt that it was a very difficult recovery. With minimally invasive surgery, which is an option for most patients, the recovery time can be significantly reduced. You can often walk in a boot on your foot as early as the day after surgery. Many patients are in regular shoes within a month. Minimally invasive foot and ankle surgery can help get you back on your feet faster and with less discomfort and scarring.

If you have any type of persistent foot pain, it’s important to consult an orthopedic expert.

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