Bunions On Feet: 10 Things You Need To Know

Important Things To Know When You Have Bunions

Bunions can be mild to severe. Learn about the important information for bunion treatment before they get too bad. SurgeryBunion.com

If you have bunions and are searching for information and the best bunion treatment options, the important information is often difficult to find.  It can be confusing simply understanding what a bunion even is, as well as how to treat it.  Trying to figure out what the best bunion surgery is can also be a difficult task.   As a bunion surgeon NYC, I've put together this list of 10 must know things that can best help manage your bunion.  

  1. A Bunion Is Not A Growth Of Bone
  2. Bunions Come In Various Sizes
  3. Bunions Can Cause A Severe Foot Deformity
  4. Bunions Tend To Run In The Family
  5. High Heel Shoes Can Worsen A Bunion
  6. Bunion Products May Alleviate Pain
  7. Not All Bunion Surgery Procedures Are The Same
  8. Best Bunion Surgery Techniques Allow For Immediate Walking
  9. Bunion Surgery Doesn’t Have To Mean Casts
  10. Bunion Surgery Can Be Performed Cosmetically

A Bunion Is Not A Growth Of Bone

People mistakenly think bunions are caused by a growth of bone. Dr. Neal Blitz

Most people mistakenly think that a bunion is growth of bone, and this is partially correct.  On surface the bunion appears as boney knobby prominence at the base of the big toe, located on the inside of the foot.  A bunion is actually caused from a structural malalignment of the big toe joint (joint subluxation) with the bones pressing against the skin from the inside.  There can be extra bone growth adding to the size of the bunion, but rarely is a bone growth solely responsible for the bunion.   

A bunion is two part problem - the bone is prominent on the inside of the foot and the big toe deviates towards the 2nd toe.  Some people have a large "bump" only, and others have a significantly deviated toe.   

Bunions Come In Various Sizes

Bunions come in all sizes. Dr. Neal Blitz

Bunions come in different sizes and are progressive.  They generally start off small and can become quite large.  The time frame for bunions to progress is variable.  In some cases the bunion progression can occur rapidly and in other cases may worsen over many years.  Some bunions may stay small forever where as others continue to get bigger.  Pain is not always associated with bunion size.  Small bunions can be extremely painful, whereas large bunions may not be painful at all.  Bunion photos demonstrate the different sizes.  

Bunions Can Cause A Severe Foot Deformity

A bunion can progress to a severe foot deformity with cross over toes. Dr. Neal Blitz

If the bunion progresses, the bunion bump can become bigger which is often associated with increased leaning of the big toe towards the second toe. The big toe can not only crowd and push against the big toe, but it can displace the second toe.  The big toe can go over the second toe, but more commonly the big toe will push underneath the second toe.  Once this happens, the second toe can develop a hammer toe (buckling of the toe joints) and dislocate.  The second toe can crossover the big toe as well (called a cross overtoe) and the other toes can follow.   In some cases, the arch can collapse with bunions, especially as they progress.  Thick calluses can form on the ball of the foot from abnormal biomechanics.   The end result can be a severely deformed foot.  Hammer toe treatments can be effective as well. 

Bunions Tend To Run In The Family

Bunions have a genetic component. Thanks Grandma!. Getty Images / John Woodcock

Bunions are thought to have a genetic component, and tend to run in the family.  Bunions occur more commonly in women than men.   Just because your grandmother has a bunion doesn’t mean that you will develop a bunion, though you may be susceptible to bunion development.

High Heel Shoes Can Worsen A Bunion

High heels and pointy toed shoes are considered "bunion makers" by many foot doctors. Getty Images / Peter-Dazeley

Most foot doctors generally consider high heels and pointy toed shoes bad for your foot health and bunion formers.  High heels can take a toll on your feet and can cause a "high heel hangover" too.  High heels place the foot in an unnatural position and place increased pressure on the ball of the foot, which can make bunion worse.  High heels may cause tightening of the calf muscle, a condition called Equinus, which can cause excessive pronation that can promote bunion formation.  Additionally,  pointy toe shoes physically promote bunion formation by pushing the big toe over.  In general, uncomfortable shoes can put you at risk for a bunion.

Bunion Products May Alleviate Pain

Night time bunion splint may limit progression of a bunion. FootSmart

 A variety of bunion products are commercially available to treat bunion pain as well as act to limit bunion progression.  Bunion pads act to alleviate direct pressure from the shoe on the bunion.  A toe spacer may push the big toe back into proper alignment, but only are effective if worn.  Arch supports may improve alignment of the bones of the foot and may limit bunion progression.  Bunion night splints are considered a long term management solution aimed to push the big toe into normal alignment.  While bunion products may not cure a bunion, they can be effective at managing the symptoms.  Most people try a variety of bunion products and bunion remedies before considering surgery.  

Not All Bunion Surgery Procedures Are The Same

Bunion surgery for large bunions is different than for small bunions. The best bunion surgery options are explained here. Dr. Neal Blitz

While there are over 100 operations for the treatment of bunions, generally only a handful are used today.  Bunion surgery procedure selection for large bunions is different than small bunions.  “Bunion shaving” is not a definitive treatment for a large majority of bunions, however the bunion is shaved down in conjunction with other procedures.  The two most common bunion surgery procedures are a bone cutting procedure or a bone fusion procedure.  Generally bone cutting procedures are performed for smaller bunions whereas bone mending procedures are for larger bunions.

Bunion Surgery Techniques Allow For Immediate Walking (No Crutches)

Bunion surgery can be performed without the need for crutches postop. Getty Images / Paolo-Florendo

Small bunions universally call for immediate walking, however larger bunions historically called for 6-8 weeks of non-weightbearing.  Nowadays larger bunions can also be treated with immediate walking bunion surgery due to modern techniques and specialize medical implants.  Not all bunion surgeons allow large bunion surgery patients walk post operatively despite the new technology and techniques.   

Bunion Surgery Doesn’t Have To Mean Casts

Modern bunion surgery techniques do not require casts. Getty Images / Izabela Habur

Modern techniques for bunion surgery have allowed some surgeons to ditch casts and crutches after surgery.  Because larger bunions involve more ‘bone work’ to correct the bunion, casting has previously been necessary to stabilize the bone segments until bone healing occurs.  Specialized bunion surgery implants can allow some surgerons to forego casting as the bones can be held steady internally.  

Bunion Surgery Can Be Performed Cosmetically

Cosmetic bunion surgery can correct the bunion surgery while keeping incisions less visible. Dr. Neal Blitz

Just because bunion surgery correction is a bone surgery, doesn't mean that it can't be performed aesthetically.  Historically incisions are placed on the top of the foot whereas some surgeons hide the incisions in a cosmetic bunion surgery approach.    Plastic surgery techniques and Bunionplasty(R) can be used to minimize unsightly scarring. Because bunion surgery is still a surgery incisions still need to be made to correct the underlying bone structure.  Laser bunion surgery is not really a viable option today.   

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