A bunion is a deformity of the big toe joint. As the normally straight big toe starts to point in the direction of the little toe, a bump develops on the side of the foot. The same deformity can occur at the little toe joint. Then it’s called a Tailor’s bunion. The bump is often irritated by shoes and the big toe joint often aches. The big toe may even push the second toe into the top of the shoe until it is irritated too. You don’t usually have to live with the pain.
While tight shoes may irritate or make an existing bunion worse, they don’t usually cause it. Bunions have been found on primitive tribesmen who’ve never worn shoes. Conversely, many millions of people who wear tight shoes never develop any deformity at all.
A hereditary predisposition is the most common cause. That is, we inherit an imperfect foot type that allows the deformity to develop over time. Arthritis can also cause severe foot deformities including bunions.
For those with only minor shoe irritation, wider shoes and spot stretching existing shoes may relieve the irritation. Padding around the bump may help too. Reuseable pads that last one–two years can be custom made of latex from plaster impressions of the feet.
Keeping in mind that the underlying cause is usually abnormal foot mechanics, orthotics are sometimes prescribed. Worn in regular, everyday shoes, orthotics help the foot walk more normally. The objective is to reduce existing joint aching and help prevent or at least slow the progression of any further deformity.
Bunions can be corrected surgically. This may be done at any time as long as you’re in good health. The time to do it is when the discomfort of the deformity is making it difficult to go about your daily activities and simple, conservative means of treatment have failed.
Bunion surgery is performed on an outpatient basis (no overnight hospital stay). IV sedation is used to make you comfortable while the procedure is done with a local anesthetic. The actual procedure performed depends on each individual person’s problem. It may involve simply removing the bump in mild cases to resetting bones in others. A new technique allows the splayed bones to be pulled together without actually cutting and resetting the bones. This new method markedly reduces the healing time. The amount of time required for healing is dependent on the type of procedure necessary to correct the deformity. The goal is a pain-free, normal looking foot.