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Bunions: Not Just Another “Bump” in the Road of Aging

High heels, high-intensity workouts, or even heredity have the potential to cause you pain in the form of bunions. These bony bumps, located at the base of the big toe, wreak havoc on your feet over time. With more than 3 million cases reported in the United States each year, sufferers are seeking solutions to avoid them altogether or obtain a pain-free stride.

If you hit this bump in the road, many treatments are available. That includes an innovative process called lapiplasty that offers shorter recovery times and helps prevents bunions from returning.

What Are Bunions?

Bunions, which are known medically as hallux valgus, are a progressive bone disorder. Several factors are attributed to their growth, none of which occur quickly. Certain types of arthritis, a genetic predisposition, individual lifestyle, and simply getting older all contribute to their development.

Bunions form on the inside of the foot at the big toe joint. Over time, the added pressure causes the big toe to gravitate behind the second toe or first metatarsal bone. Smaller bunions, known as bunionettes, also are known to form on the outside of the pinky toe.

Pain and symptoms from bunions vary in those diagnosed and while some may never experience any complications. If you do experience pain, your primary care provider may refer you to a podiatrist, a doctor who specializes in feet, or advise physical therapy and perhaps an orthopaedic surgeon, depending upon your individual circumstance.

Bunion with Displaced Toe

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe. This results in a bump on the outside edge of this toe. The skin may be red or irritated, and there may be swelling at the base of the big toe. The big toe may point toward the other toes (be displaced).

Risk Factors of Bunions

Your risk of bunions increases if you have a family member suffering from them, or an inherited structural condition or foot defect that weakens joints, nerves and muscles, or causes misaligned limbs. Being diagnosed with Rheumatoid arthritis also increases your risk of bunions, as does overpronation. This is a condition that causes the foot to roll inward while walking due to low or weak arches.

Bunions can deform the underlying bone, which may or may not include symptoms. It can also cause hammertoe, which can cause pain and discomfort as well as forcing toes to cross over one another, a condition called metatarsalgia, which causes the ball of the foot to swell and ache, or the formation of thick calluses around the afflicted area.

Symptoms of Bunions

Most individuals suffering from bunions experience one or several of the following symptoms:

  • Large bump on the outside of the big toe
  • Swelling around big toe
  • Red, sometimes shiny in color
  • Numbness
  • Warm to the touch
  • Tender to the touch
  • Pain even in comfortable shoes
  • Limited mobility

Women are more susceptible to bunions than men, most likely due to wearing high heel and tight shoes. Adolescent girls, ages 10 to 15, also can acquire bunions, but it’s rare. Over time, the foot bones are squeezed into an unnatural formation causing damaged anatomy and pain. It’s also a well-known fact that as we age, or gain weight, our feet spread and that worsens the problems already in place or triggers the development of bunions.

How to Avoid Bunions

This nuisance may not be completely avoidable. But there are some things within our control to prevent bunions or allow us to find comfort in everyday activities once they rear their ugly head.

Maintaining a healthy weight for your age, bone structure, activity level, and height are important for your overall health since obesity is associated with chronic disease and illness. Similarly, gaining weight promotes the spreading of our feet as mentioned earlier. Consider how pregnancy often delivers not only a baby but also a larger shoe size. Women often report going up a half or full size compared to where they were pre-pregnancy. This is due to the added weight gained over the nine months.

It also goes without saying that people should wear comfortable shoes with wider toe boxes, and avoid pointy toes or high heels. While some researchers say that tight shoes may cause bunions, this has not proven to be true. However, they can aggravate the situation.

Along with wearing proper and comfortable footwear, over the counter medications that include analgesic and non-steroidal drugs (such as ibuprofen or naproxen) can numb areas or reduce inflammation. This may bring temporary relief. Additionally, braces or inserts can be purchased at drug stores or even doctor’s offices for additional support and padding.

Treatment of Bunions

When home remedies and self-care no longer seem to be working, people have alternate options based upon the severity of their bunions, physical impediments, and doctor’s recommendation. These may include shaving calluses or specialized care such as physical therapy, or even include surgical options.

One of the first things we do in our office after a consultation and patient physical is to order an X-ray, which allows us to see the bone and presence of any bunion. Once an actual diagnosis is made, the proper course of treatment is determined.

Sometimes cortisone injections are administered in the doctor’s office for temporary relief. Their purpose is to reduce the inflammation in the area that cushions the bones longer than over-the-counter medications, thereby making physical activity pain-free. However, the injections themselves are described as painful. Talk to your provider before making this choice.

Surgical procedures typically are a last resort for people experiencing bunions and not everyone is a candidate. If home and cortisone treatments fail to bring relief, or if an individual has a genetic deformity, he or she may need surgery to correct problems and reduce pain.

Removing damaged joints, tendons, or correcting bone alignment may be done with one of the following procedures:

  • Surgical Repair – focusing on tendons, ligaments (the fibrous connective tissue that connects bones to other bones and keeps the structure in place), or other tissues around the joint. This surgery either reinforces the structure of the joint or lengthens the toe.
  • Arthrodesis – using screws, wires, or plates during surgery, this procedure removes the swollen joint surface.
  • Osteotomy – realigns the joint by using screws, plates, or pins to fix the bone deformity.
  • Exostectomy – often used in conjunction with osteotomy, the bump on the joint itself is removed.

Lapiplasty® Offers New Bunion Treatment Option

The latest surgical treatment, offered at UPMC in Central Pa., is Lapiplasty, a 3D bunion correction targeting the source of the deformity. In the instance when the bone becomes unstable and leans sideways, this outpatient surgical option restores the anatomy to its natural position without cutting the bone. In doing so, it fixes the problem the right way the first time.

For 87 percent of those with bunions, traditional surgery often fails to correct the unstable joint and the bunions return. Now, with the latest, patented titanium technology, patients are finding a permanent solution with faster recovery and less pain.

Also unique to Lapiplasty, most patients are able to walk within days of surgery without a cast. And they can be back in sneakers in a couple months.

For other types of surgery, the recovery time ranges anywhere from four to six weeks depending upon the individual and his or her overall health status prior to their chosen procedure. Depending on the procedure performed, patients often wear a surgical boot during the first three to six weeks to protect the area where surgery was performed.

Don’t Put Off Treatment

There’s a reason to remain hopeful if you encounter this common bump in the road of life. To talk to a specialist about your bunions, call UPMC Foot and Ankle Specialists at 717-960-8970.