A Bunion is a bony bump that forms on the joint at the base of your big toe.

The medical term for bunions is “Hallux Valgus”. Hallux means the “big toe” and Valgus means “deviation away from the midline.”

YES!!

Bunions are largely heriditary.

Pointed toed shoes can aggravate the condition and narrow shoes make them hurt more. But, for the most part you get bunions from your ancestors.  

The long-term complications of a neglected bunion deformity are pretty well documented. These include arthritis, increased deformity, and transfer pain to other parts of the foot.

Arthitis.  

That is because the joint is  not lined  up correctly. If you can imagine that your knee were bent sideways by 30° and you walked on it for years that would create a pretty bad knee joint over time. 

Pain in other locations and other deformities.

Hammertoes are common with bunions. These occur because the toes are trying to stabilize the foot. Bunion deformities often disrupt the weight bearing surface, causing transfer pain and calluses to the adjacent parts of the bottom of the foot. 

Decreased quality of life.

Clinical  studies on patients with symptomatic bunion (hallux valgus) deformities show significant decrease in quality of life.  General health scores, vitality scores, social function scores and metal health all are affected.  Arthritis, Balance issues, impared gait and fall risk are all factors.

J Foot Ankle Res. 2011; 4(Suppl 1): A8. Published online 2011 May 20. doi: 10.1186/1757-1146-4-S1-A8   epidemiology in impact of hallux valgus, the colon more than just bunions:  Edward Roddy the PMCID: PMC3102914  

The good news is that there are many procedures to correct bunion deformities.  Some of these are geared towards younger healthy patients and others are geared towards the more mature patient who just wants to get the foot in a shoe. We have performed bunion surgeries on patients as young as 13 and as old as 90 years old.  

Bunion deformities can come back.  It is estimated that approximately 25% of bunions recur after surgery.  In my experience, these are almost all due to under correction in the first place.  Inadequate correction results in bunions coming back.  There are also other factors that cause  recurrence: patient compliance, stability of the patient’s foot, additional toe deformity that isn’t corrected at the time of  the surgery, and rotational deformity in the metatarsal.  All of these need to be taken into consideration to minimize the risk of recurrence.   Selecting the right procedure and aggressive correction keeps that to a minimum.   Surgeons that use intraoperative x rays can tell immediately if the angle of correction they have used is adequate.   Remarkably, most doctors don’t use these.  At Next Step Foot & Ankle Clinic, we use intraoperative x rays with every bunion, every time.An example (image) of a terribly under corrected bunion that came into our office. The image on the right is after we appropriately corrected the bunion. The surgery on the left was doomed to recur from the start so the question of “will my bunion come back?” is largely dependent on the procedure selected and how skilled the correction.

Bunion (Hallux Valgus) has risks and you need to be aware of them if you are considering surgery. The most common is recurrence which we discussed above. Others are less common but can occur and they include chronic swelling or pain, nerve damage or numbness, infection, poor alignment or loss of fixation of bones, slow or non healing bones, painful joints or other structures.

Overall, bunion surgery when performed correctly has a very high satisfaction rate.    

Bunions form when you regularly wear tight and narrow shoes. It often happens to women because of high heels and pointed toe boxes that are prominent in women’s shoes. Those squeeze the toes and put pressure on the outside of your big toe, gradually pushing it inwards and out of alignment.

When a bunion is formed, the more you wear those shoes, the more uncomfortable and worse it gets.

If your podiatrist identifies that the pain in your foot is from a bunion, there are many steps you can take to relieve the pain and stop the bunion from getting worse.

They include:

• Wearing wide, low-heeled shoes to ease pressure on your foot
• Wearing protective pads to reduce discomfort on your toes
• Taping your toe
• Icing your joint
• Wearing toe separators