What to do about a bunion

April 1, 2022

Do I Have A Bunion?  

People commonly notice a prominence with their big toe on the inside of their foot. In many cases this constitutes a bunion (hallux valgus). This can be unsightly and bother the patient. But it also can cause significant pain. Most commonly it causes pain while the patient wears shoes. Some shoes may be worse than others; however, tighter shoes may be more problematic. Historically, orthopedic foot and ankle specialists have often blamed the shoes for causing a bunion. There is some scant evidence for this, but in general we blame genetics for half of bunion formation. Environmental factors as the patient ages make up the rest that we don’t quite understand. In most cases, if your bunion is painful enough that it bothers you, then it is worth having Dr. Miller evaluate the pain and understand your options.  

Orthopaedic Evaluation Of My Bunion:

When a patient comes to the office complaining of bunion pain, the first thing Dr. Miller will do is have the patient stand and examine them. In most cases there is a deformity with potentially some redness from rubbing on the inside of the big toe. This is also met with the big toe sometimes impinging or resting onto the second toe. In more severe cases, the other toes can suffer a deformity over time as well. Additionally, we want to evaluate for any arthritis in the big toe which is where x-rays come in. We check the big toe for arthritis, deformity, and we identify and measure the severity of the bunion. This will help us determine if surgery is necessary and how to fix and correct the pain and deformity.

Types of treatment:

1. Non-surgical: Initially, we always try non-surgical treatment and often the patient comes in having already tried what we recommend. Shoe changes and modifications to allow accommodation to the deformity is initially the first option. Sometimes taking the existing shoes and stretching them out or accommodating to the deformity with an insert is helpful. Sometimes it can be as simple as a pad in mild cases. There are several options for shoe protection, and it is something Dr. Miller as your orthopedic surgeon can go over. Sometimes an anti-inflammatory is effective and rarely injections are helpful because these are often temporary measures.
2. Surgical: If non-surgical treatment has failed, then you and Dr. Miller may decide that surgery is the best option. This would be decided after discussion with Dr. Miller going over the risks and benefits of the procedure and any medical associated risk involved. Bunion surgery is an outpatient surgery and can be performed successfully in less than an hour and you’ll go home the same day. There are several different ways to correct a bunion. Dr. Miller will go over these options with the patient in detail to ensure they know what to expect. Based upon the examination and the imaging, the patient’s surgery is tailored to the foot and the deformity it presents. As the understanding of this deformity and technology has advanced, most patients can undergo bunion surgery now through a minimally invasive approach. Our patients have experienced early wound healing, early weight bearing, improved range of motion, and decreased post-operative pain when having the bunion corrected with a minimally invasive approach. Most patients can begin walking 2-3 weeks after surgery. 
   

Post-Surgical Care:

After surgery the patient is asked to protect the foot with the dressings placed on the foot, elevate the lower extremity, and modify their activity. They are then seen back in the office within 1-2 weeks where dressings are changed, and further instructions are provided. Is it time to get your bunion evaluated? Contact Dr. Miller for honest expert opinion and advice. If someone you know is needing foot and ankle care, Dr. Miller specializes in foot and ankle orthopaedics and is available at several locations around the Cincinnati area. Contact us today for more information! Click here to learn more and schedule an appointment with Dr. Miller for your foot and ankle issue.