Who ever named it a "bunion?" Probably the same person who
named an enlarged thyroid a "goiter", but seriously,
bunions are the common description of a bump on the side of
the big toe. Really they are much more than that.
Bunions are known in medical terms as Hallux Abducto Valgus
which in English is a crooked big toe joint with a bump on
the side. This is actually a progressive misalignment of
the big toe joint which starts with a slight leaning of the
big toe toward the second and then gradually produces the
characteristic bump and joint symptoms. In the late stages
of progression, the big toe actually can overlap or
underlap the second and cause reactive hammertoes
(contracted) of the other toes. Even though they are
extremely common, most people wait until they have
significant symptoms and deformity before they seek medical
attention. Often they have had pain in shoes and with
activity for years when they finally come into the office.
This is due to the misconception that they always require
surgery for treatment.
What causes bunions? No, it's not always the shoes! (But,
they don't help) Bunions are caused by the faulty
biomechanics of your foot structure that you inherited.
Couple that with high heeled shoes or even just shoes that
crowd your toes (listen up guys who wear cowboy boots!) and
you are prone to the formation of bunions.
Symptoms of bunions are the prominent bump with redness
from rubbing in shoes, grinding of the joint, pain,
swelling, burning and occasionally even numbness.
Diagnosis of a bunion is done by x-ray findings together
with physical exam. A bump is not necessarily always Hallux
Abducto Valgus, so a complete podiatric exam including
x-rays should be done to evaluate your condition. Many
people actually have arthritis of the big toe joint or even
just a cyst overlying the joint and think they have bunions.
Treatment includes shoe gear modification, an orthotic
device to control the abnormal biomechanics, padding,
anti-inflammatories or injection therapy to decrease
inflammation, and at the later stages, surgery.
When is surgery needed for bunions? If you have pain every
day, in every pair of shoes you own (including your
athletic shoes) and you have treated your condition with
conservative therapy without any relief; it's time to
discuss bunion surgery. Surgery should never be
contemplated without pain and activity limitations. There
are many advances in bunion surgery and varied procedures
depending on your foot type, the stage of your deformity,
your activity level, your medical history, and your age.
Make an appointment to discuss surgery with your podiatric
foot and ankle surgeon if you have progressing symptoms.
The American College of Foot and Ankle Surgeons cites a
survey that showed 96% satisfaction after bunion surgery
with a board-certified foot and ankle surgeon. 96% of the
survey respondents identified pain relief as a desired
outcome of the surgery, and 86% also said they hoped to
improve their walking and increase their physical activity
following surgery. On a scale of 1 to 10 with 10
representing "much pain," the survey respondents averaged a
score of 7 when assessing their pain before surgery, and
the average score dropped to 2 when they assessed their
pain six months after the operation. 92% said they were
able to increase their physical activities -- walking,
running, golf, tennis, exercise -- and 90% said they would
recommend bunion surgery to others. This is great news!
Many people fear the surgery more than pain every day in
their shoes! Obviously, this fear is unwarranted!
Fear of surgery should not keep you out of the office
because 80% of patients who come in asking for bunion
surgery leave with a conservative treatment plan. Call or
contact your podiatric foot and ankle surgeon for an
appointment today to get your questions answers. Don't live
with the pain of bunions for one more day.
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For more information on foot and ankle health, visit our
website at http://www.faant.com or my blog at
http://www.myrundoc.com . For a podiatrist in your area,
visit the American College of Foot and Ankle Surgeons
consumer website at http://www.footphysicians.com .
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