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BUNIONS Bone prominence on inside of big toe joint

CAUSE:

  • Poor foot posture, particularly low arch or high arch feet, cause mechanical imbalance of the joint
  • Hereditary predisposition and genetic influences
  • Aggravated by activity, exercise, weight, improper shoe gear fit, such as tight shoes or shoes that taper aggressively at the forefoot

SYMPTOMS:

  • Pain deep inside the joint, even when non-weight bearing, while resting or deep pain felt in the joint if awakening during the course of the night
  • Pain in closed shoes
  • Occasionally numbness along the inside of big toe when wearing closed shoes
  • Painful hard skin (callouses) on the ball of the foot under the big toe joint

SIGNS:

  • Enlarged bone with redness over the area.
  • Crooked big toe
  • Bunions are sometimes associated with other toe deformities (hammertoes)

TREATMENT:

  • Proper fit of shoes in width and taper of toe box of shoe
  • Orthotics (arch supports) can help poor foot posture to slow down or stop the progression of the bunion if conservative care is chosen by the patient.  Orthotics also help to maintain long term mechanical balance of the joint if surgery is performed so that the likelihood of future recurrence of the bunion is minimized.
  • Surgery to reduce the bump and align the big toe joint - IT IS NOT MEDICAL STANDARD OF CARE TO DO SURGERY ON BOTH FEET AT THE SAME TIME
  • The surgical procedure is done outpatient under either straight local anesthesia or twilight sleep. It takes between 60 and 90 minutes to perform. Your postoperative course will be reviewed with you by your physician if you choose surgery.
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