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Got a case of the bunions? Here's what you need to know


Korey Huyler for GBMC

April 3, 2018
A quick primer: A bunion is a bony bump on the joint at the base of your big toe. It develops when your big toe pushes against your next toe, forcing the joint of your big toe to enlarge and stick out — because of this, the bump (bunion) and the joint may be red and painful. Yes, bunions are incredibly painful, especially when walking.

“Bunions are bony prominences on the inside (medial side) of the great toe metatarsal phalangeal joint,” explains Dr. Steven Kulik, an orthopedic foot and ankle surgeon at Greater Baltimore Medical Center (GBMC). “Because your shoe puts pressure on the area, the bunion hurts. The smaller the shoe, the more pressure on the bunion — and the more pain.”

If you have a bunion, surgery could be the answer to your pain problems; it corrects the deformed area of the foot near your big toe. Also known as a bunionectomy or hallux valgus correction (hallux valgus means “foot deformity” in Latin), the outpatient surgery typically takes between one and two hours and eight to 12 weeks to recover, explains Kulik.

“Bunion surgery, if done well, will relieve the pain in your foot and allow you to walk comfortably,” says Kulik. “It will also allow you to wear comfortable shoes. It’s a permanent solution that fixes your problem.”

Before choosing surgery, many people get relief from bunion pain by wearing larger shoes with a wider toe area or cushioning bunions with protective pads. Ice and anti-inflammatory medication are also useful. If you can’t find a way to relieve the pain with these options, surgery just might be the answer.

“Bunion surgery is a realignment surgery,” explains Kulik. “Since there are different types of misalignments, there are many different types of bunion surgery. It’s best to find a surgeon who can perform different types of bunion surgeries to accommodate your deformity, rather than a surgeon with a ‘one size fits all approach.’ A foot-and-ankle-trained orthopedic surgeon, who is a member of the American Orthopaedic Foot & Ankle Society, fits that description.”

Signs you should get surgery:
  • Your pain restricts or prohibits you from completing everyday routines or activities.
  • You can’t walk more than a few blocks without severe foot pain.
  • Your big toe remains swollen and painful even with rest and medication.
  • You have pain bending or straightening your big toe.
Simply stated, the indications for bunion surgery are pain, deformity and an inability to find any shoes that are comfortable for everyday use.

“The best candidates are people in pain, those who have trouble finding comfortable shoes to wear, and people who have failed with conservative treatment, which consists of wide shoes, ice, and occasionally anti-inflammatory medications,” Kulik says. “Though some leather shoes can be stretched over the bunion by a shoemaker, if these measures fail, then surgery needs to be considered.”

Good news: Naturally being in good health with good blood flow in your feet will make you an excellent candidate, as well. And, after surgery, you should be able to live a normal life wearing many different shoes.
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