If your big toe is behaving badly, leaning over too close to its neighbor, bumping into your shoe, going all stiff and turning an angry red, maybe it’s time for it to straighten up and learn some manners! We’ll help you understand how it got to be so obnoxious and give you hints for dealing with it so you can be more comfortable. It may be that we’ll have to perform bunion surgery if it keeps giving you trouble.
What Causes Bunions— Heredity or Environment?
There are two schools of thought on this. Some say the bunion forms because you have an inherited foot structure that makes your bones more prone to move out of position. This could include having flat feet or low arches, which is often accompanied by overpronation—your foot leans too far to the inside with each step. This foot structure and motion puts a lot of extra pressure on your big toe, forcing the tip toward your other toes and the MTP joint at its base out to the side.
Others say it’s the fault of your shoes. Women get bunions more often than men, and women tend to wear shoes that are too small, too high-heeled, and too pointed in the toes. There has to be a connection, right? If your toe is crammed in too tightly with its neighbors, it makes sense that it would eventually get bent out of shape. Even those who blame these bumps on heredity concede that such footwear can hasten the progression of this deformity or make it more painful.
There are a few obvious medical causes as well, such as bone degeneration with arthritis, neuromuscular problems that affect how the nerves and muscles in your feet function. Injuries to the feet, and activities such as ballet dancing, can also cause this deformity to develop.
Teaching Your Bunions to Behave
If you catch this bony growth before it gets too bad, you may be able to guide it back on the straight and narrow. Start by buying better shoes—those that have plenty of room for the toes and lower heels that won’t force your toes into the front of the shoe. Do gentle stretches and range of motion exercises with the toe to keep it limber. We can show you how to use cushioned pads to protect it from rubbing against your shoes. We can even recommend taping procedures to maintain proper foot position, or design a custom orthotic that helps correct your foot function, so your gait is more straightforward and pressure is taken off the toe. If it is swollen or painful, you can try icing and massage for relief.
Getting Professional Help
If these measures do not improve your condition, bunion surgery may be necessary, because these deformities will not reverse themselves or get better without treatment. There are many possible surgical procedures, and we will explain the one that we think will work best for you. Many are done on an outpatient basis without full anesthesia, while more severe cases may require a general anesthetic and brief hospitalization.
Some procedures simply remove the bony protrusion. Some address unequal tendons so that they can better hold the bones in place. Some use a wire to reposition the joints, while others cut and realign the bones into proper position. Whichever one we recommend, know that our goal is the best possible outcome for your comfort and mobility. Know also, that recuperation will probably take some weeks, and you may need physical therapy to restore full function afterwards. Wait until we give the go-ahead before resuming activity. Being active too soon can delay your recovery and healing.
Don’t despair of ever getting your big toe back to normal, or think you have to put up with the pain it is causing. Please call our office with any and all questions you have about your bunions or bunion surgery techniques. We want you to fully understand your options so you can make the best decision for treatment. Call Rocky Mountain Foot & Ankle Center in Wheat Ridge, Evergreen, Granby, or Golden, CO, by dialing (303) 423-2520, or set up an appointment through our website. We are ready and eager to help you.
Photo credit: marin via freedigitalphotos.net