Understanding Bunion Pain

A bunion, or hallux valgus, is a painful foot deformity that affects millions of people. While often associated with the enlarged joint at the base of the big toe, the consequences of this condition extend far beyond the obvious. And without proper care, symptoms tend to go from bad to worse.

Reconstructive Foot and Ankle Institute, LLC sees plenty of patients who don’t have familiarity with this issue when they’re first diagnosed, so for this blog post, we’re providing some patient education on the subject.

The Root of the Problem

According to Dr. Michaels, bunions can sometimes be traced to your foot’s unique structure.

• “Hallux valgus is more likely to occur with certain foot types,” he explains. “A common scenario is one in which the arch rolls down excessively (referred to as “pronation”).

• “Preventing this extra motion of the arch,” he adds, “will go a long way toward stopping or reducing the drift of the first metatarsal.”

For many patients, however, confusion stems not from the structural concerns, but from the fact that the bunion itself isn’t always the starting point for aches and pains.

• “The discomfort often begins on the side of the second toe, not the bunion itself,” he explains. “The enlarged big toe exerts significant pressure on the neighboring digit, leading to various skin issues.”
• “This is especially true for those with underlying conditions likediabetes or poor circulation connected to arterial disease.”

The Progression of Bunion Pain

As the bunion progresses, Dr. Michaels informs us, it causes “abnormal joint movement, resulting in cartilage degeneration, inflammation, and bone spur formation.”

• “This bony growth contributes to the increasing prominence of the bunion.”

And although many quickly cite the inherited nature of this issue, there are other factors in play.

• According to Dr. Michaels, “[w]hile genetics play a role in bunion development, it’s often the ligament’s ability to maintain joint stability that determines the severity of the condition.”

Treatment Options

Fortunately, many people can manage their bunions without surgery through conservative treatment options, including:

• Podiatrist Recommended Footwear: Choosing shoes with ample toe box space is crucial.
• Custom Orthotic inserts: These devices provide support while alleviating pressure.
• Bunion Splints or Sleeves: Each option can help correct the alignment of the big toe.

While the above options are always prioritized whenever possible, corrective surgical procedures are sometimes necessary to address the core of the problem.

Surgical Options

• “Over a hundred different surgical procedures have been used to correct hallux valgus…Much depends on the age of the individual, their symptoms, the specifics of their deformity, and their biomechanical function.”
• “Not everyone needs to have a complete reconstruction, with cutting of the metatarsal bone and realignment of the head. For some, a simple bump removal is all that is required to resolve their complaints.
• “One approach with a long history of success involves cutting (precisely) through the neck of the first metatarsal bone and shifting the head over, back into position.”
• “Different bone cuts have been performed, each with its own nuances and drawbacks.”

While cases vary, Dr. Michaels cautions that managing bunions always takes time and expert care, and “one size does not and should not fit all.”

That said, accurate, detailed analysis of anatomy and biomechanics is always a great first step, providing accurate information and allowing the formulation of a precise treatment plan.

Battling bunions but unsure of where to turn? Reconstructive Foot & Ankle Institute, LLC offers comprehensive podiatric services! Call us at 301-797-8554 or contact us to schedule an appointment. Located in Hagerstown & Frederick, MD, we’re ready to meet any of your foot health needs.

Don’t forget Dr. Michaels’s motto:

“If it’s below the knee, think of me!”