If a conservative approach does not alleviate your symptoms, then surgical correction may be necessary.
Long-term sequella of a bunion deformity ranges from an irritating bump to a painful arthritic joint. It may lead to thickening of the skin on the bottom of the foot, overlapping of the first and second toe, callus formation of the second toe, ingrown nails, limitation of motion of the great toe joint and pain on the ball of the foot.
Hallux Valgus require medical evaluation if signs and symptoms persist or worsen. An individual should seek the advice of a surgically trained, board-certified podiatrist trained in the surgical management of these types of deformities. A simple examination will assess the structural integrity of the foot for excessive pronation and ligamentous laxity, which can be contributors to this type of deformity. X-rays will be required to determine the extent of the bunion and any destructive changes that may have occurred within the joint. After careful examination, a course of treatment will be discussed.
From a non-surgical approach, a change in footwear that has a wide toe box may help. Other options may include taping, steroid injections to reduce inflammation, over-the-counter anti- inflammatory medications, spacers to help separate the toes, and inserts that are placed in the shoes, which will help stabilize a structural biomechanical abnormality that contributes to the progression of a bunion deformity.
If a conservative approach does not alleviate your symptoms, then surgical correction may be necessary. Close evaluation of the deformity by a board-certified podiatrist is essential to the proper surgical approach. The most important consideration is the angle between the first and second metatarsal. This is called the IM (Intermetatarsal angle). Typically, the higher the IM angle the longer the recovery. Following surgery, an individual may find it possible to walk on the foot almost immediately. Others will need to recover for six to eight weeks and, in many cases, even longer. Recovery is based on the individual, how well the body heals itself and the type of bunion procedure they have.
If you or someone you know suffers from this common disorder, it is important to have this addressed in a timely fashion. Long-term effects of this deformity may lead to more deformation of the foot and adjacent toes. It may also lead to progressive arthritis in an otherwise good joint. Not addressing the deformity early causes abnormal wear of good cartilage and is irreplaceable. FBN
By Anthony Rosales, DPM, FACFA
Anthony Rosales DPM, FACFAS, a foot surgeon with offices in Flagstaff and Page, is board certified in foot surgery by the American Board of Foot and Ankle Surgery. He is a member of the American College of Foot and Ankle Surgeons.