What Should I Do About My Bunion?

So, about that bunion.

You’ve probably realized by now that the bump on the side of your foot isn’t going away any time soon. In fact, you think it’s getting worse, slowly but surely.

Maybe the unwelcome visual reminder of your deformity alone is enough to convince you something needs to be done. You’re simply embarrassed by the way it looks, or you’re worried about what the future might bring.

However, if you’re like most people finally beginning to seriously consider treatment, you’ve already moved to the next stage. You got used to the aesthetics of the bunion, but now it’s making itself known in other ways. You can no longer find a pair of shoes that doesn’t pinch the front of your feet uncomfortably. You find that you can’t walk as long or as far as you used to without serious soreness. The joint is stiff and doesn’t want to cooperate.

What should you do about it? First things first: call a podiatrist. For example, your humble blogger Darren Elenburg.

Get Evaluated by a Specialist as Quickly as Possible

The truth is there’s not one surefire trick or solution to dealing with a bunion. Not every bunion requires surgery to manage effectively (though surgery is the only way to get rid of the bump and actually put the bones back in place). A range of conservative approaches might help you. And even if surgery is necessary, there are quite literally dozens of different procedures and techniques widely used by surgeons across the world.

But this is also very true: although there are plenty of options for treatment out there, the longer you wait, the fewer good options you’ll have left. Is your bunion small, not causing you any pain, and not limiting your activities? There’s a good chance we can keep it that way, at least for the medium-term future. Is your bunion big and making your life miserable? You’re probably going to need surgery.

So, you should always get your bunion checked out as soon as possible, and furthermore you should choose a foot and ankle specialist with a lot of experience treating bunions with both conservative and advanced surgical care. That doctor is going to be in the best position to evaluate your condition and your personal needs accurately, and provide solid advice and effective treatment options to meet those needs.

Start with Conservative Care

So let’s say you’re one of the lucky ones. Your bunion is still pretty mild to moderate. Pain is minor and intermittent. In that situation, we can usually help you find a mix of conservative treatments that allows you to function normally without pain, and keeps the rate of deformity progression to a minimum.

These options might include things like:

·       Wider shoes to fit a bunion deformity without pinching.

·       Arch supports or custom orthotics to better distribute pressure when you walk and support weakened arches. (Often structural foot problems are a primary cause of the bunion.)

·       Non-medicated bunion pads to cushion the bunion against pressure and friction.

·       Tape or splints to hold the toe in the most normal possible position.

·       Foot and toe stretches that relieve tension and strengthen the muscles that support toe alignment.

·       Pain and inflammation management strategies such as over-the-counter medications, icing, or cortisone injections. (We use ultrasound guidance to greatly enhance the effectiveness and safety of these injections.)

Although none of these options will “fix” your bunion or make the bump any smaller, they are often very effective at allowing those with mild bunions to continue to lead full, pain-free lives. They are our first choice for treatment in most cases.

A Better Way to Do Bunion Surgery (If You Need It)

Of course, for some people the bunion has simply gotten too large, too painful, and too difficult to manage. It must be fixed, which means bunion surgery.

As we said earlier, there are quite literally dozens of bunion surgery procedures out there. Cutting and realigning bones (osteotomy). Fusing joints (arthrodesis). Rebuilding joints. Replacing joints. Even within those categories, there are disagreements about where to make the incision, what tendons to reinforce or transfer, etc.

However, in our opinion most of these surgical options are lacking in one way or another, usually because, while they may remove the obvious deformity, they usually don’t fully correct the underlying instability. In most bunions, the metatarsal bone becomes displaced both outward, upward, and rotationally; common surgeries address only one or two of these displacements (and almost never rotation). If you don’t fix all three, some instability remains, and there’s a greater chance the bunion will return later in life.

Our office is proud to be one of the few around offering the Lapiplasty procedure for bunions. This innovative surgery uses a unique tool to fully reposition and realign (up, down, and around) the metatarsal bone without cutting it, then fusing the unstable midfoot joint. We’ve found that this not only produces much better and more reliable results on average, but is also quicker to perform and allows a faster return to full weight bearing activity for the patient.

Don’t Wait Another Day

Make today the day you invest in a pain-free future. Give us a call a see us about your bunion. I know we can help you. Dial (405) 418-2676, or request an appointment online.