A bunion is a bony bump that forms at the base of the big toe and may result in the big toe drifting toward the second toe. Several things are thought to cause bunions, such as wearing narrow, tight-fitting shoes, pressure on your big toe joint from having a flat arch and some may even inherit the deformity from parents. Bunions can be unsightly, make shoes fit badly and can be very painful.
Evidence shows that conservative intervention for bunions provides relief from symptoms but does not reverse the deformity. These non-surgical interventions include choosing shoe wear with a larger/wider toe box, various shoe orthoses to reduce stress on the big toe, and physical therapy.
It has been proposed that an orthotic to improve arch support may improve the alignment of the first metatarsal, and therefore discourage progression of hallux valgus. Orthotics have been successful in the relief of pain associated with other conditions like plantar fasciitis and rheumatoid arthritis.
If conservative methods (such as those listed above) don’t work, then you may need surgery.
Bunionectomy surgery is not typically done for cosmetic reasons and candidates for surgery usually have one or more of these symptoms:
In general, the goals of bunionectomy surgery are to realign the MTP joint, relieve pain, and correct other bony deformities of the first ray (bones that make up the inside portion of the foot and toe).
There are many different types of surgeries but the most common are the osteotomy and the arthrodesis. The osteotomy is done much more frequently and is the removal of bone and realignment of the joint. The arthrodesis is a fusion of the joint and is done to combat severe arthritis and pain. It is not done as often because it results in an inability to move the joint at the big toe.
Bunionectomy surgery often includes repairing the soft tissues around the big toe as well, as they typically become too tight on one side and loose on the other side due to the malalignment.
The time to recover varies a lot, depending on which surgery is done, but you will most likely be on crutches or a walker for a couple weeks and then have a walking boot for up to 8 weeks. It usually takes 4 to 6 months to return to all normal activities including aerobic exercise.
If you want to schedule an appointment with JOI Rehab, you can call 858-7045.