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Article Authors: Gordon Slater| Tandose Sambo 

Does a distortion in the big toe area make your foot difficult to put on? Do you experience joint and inflammatory pain? If so you probably have a bunion, which is also known as hallux valgus.

What are the symptoms of a bunion?

Even if, at first the bunion is benign, it can escalate to a more painful condition. Hallux valgus can quickly cause uncomfortable symptoms, ranging from simple local pain to ingrown toenails and mobility disorders.

Here is an overview of the symptoms caused by the foot bunion:

  • Appearance of a lump at the base of the big toe created by a characteristic deflection of the joint
  • Beginning of the movement of the big toe towards the 2nd toe
  • Appearance of joint stiffness and pain when moving straight
  • Second toe that deforms and becomes claw or hammer
  • Pain in the joint (osteoarthritis)
  • Bursitis
  • Ingrown nails

Possible complications

While the bunion is usually easy to treat when detected early, it can also lead to more severe symptoms without adequate treatment.

Here is a list of complications that may occur in response to a bunion.

  • A hallux limitus, then a hallux rigidus
  • The disarticulation of the second toe
  • Skin infections that appear because of calluses
  • A change in posture in response to muscle compensation

What causes a bunion?

There are several causes that can explain the appearance of a bunion. These may include family history, inappropriate footwear, age of the person, etc. Here are some of the causes often observed in practice.

  • Flat foot
  • Hereditary factors
  • Wearing shoes too narrow
  • Big toe too long (Egyptian foot)
  • Ligamentous hyperlaxity (ligaments more flexible than normal)
  • Hypermobile hollow foot (foot with a high arch, but which collapses when walking)
  • Pregnancy or menopause that can lead to sagging foot and forefoot enlargement
  • Some mechanical factors such as hyperpronation, hypermobility of the foot, raised or low arch

Keyhole surgery can address many of these problems and is an emerging technique compared to traditional “open” techniques. 

Minimally Invasive Bunion Surgery 

When bony accumulations or growths develop on the exterior of the big toe joint, a bunion is the final outcome. The toe eventually loses its alignment with the rest of the toes, and it becomes painful to carry out general activities such as walking and running. Many people avoid treatment till it’s too late. With minimally invasive surgeries, normal activities can be restored within a short turnaround time. Minimally invasive bunion surgery or bunionectomy, is the solution to removal of painful bunions. Contact your foot and ankle surgeon today for a consultation. 

Usually in the progression of a bunion, patients believe that they can ignore the condition, and use painkillers as a means by which to “forget” the pain. This process is a temporary fix, and surgery is the best way for the pain to be permanently relieved. The condition is internally generated, and the best way to relieve it is from internal treatment. If left untreated, bunions will naturally progress, and in the most severe conditions the second toe will overlap the big toe. The shift will cause a realignment of the foot and can lead to even more problems down the line. Walking will be a challenge. Your orthopedic surgeon will prescribe surgery when the pain experienced is becoming unbearable, and the onset of alignment challenges is on the verge of developing. 

TRADITIONAL SURGERY VERSUS MINIMALLY INVASIVE BUNION TREATMENT

The image to the left is a visual of a patient with a bunion. The protrusion to the left is eventually painful. Wearing shoes becomes a challenge because the width of the foot is wider than normal. With the width to length ratio affected, finding appropriate shoes becomes a challenge.The minimally invasive bunion surgery procedure used to remove bunions is a significant change to previous traditional procedures which treated the bunion via large incisions during surgery. These incisions were in the regions of approximately 5 cm. With minimally invasive bunion surgery, incisions less than 3 mm are created on the site. The operation, with less impact on the area, facilitates faster recovery, and more flexibility in the big toe. For persons with bunions, the procedure is best for mild to moderately painful bunions. Any condition more severe will require more traditional open surgery. 

Post Surgery Results: 

The image to the right, is the foot of the same patient, six months post bunion operation. With less scarring and minimal pain, normal activity resumption is an advantage of minimally invasive bunion surgery. 

Temporary Treatments for Bunions: 

If your condition is very mild, you can ease your pain with mild anti-inflammatory treatments. Recommended painkillers include over the counter drugs like ibuprofen and acetaminophen. Adjusting your shoes in the interim will also help. Wear flatter shoes until the foot has been treated. Inserts such as gels will help you. In severe cases, you might need a foot brace. Your foot and ankle surgeon will advise, but there are treatments you can use until you get a final opinion. 

Reference Article: 

  1. Minimally Invasive Surgery Article: https://www.healthxchange.sg/news/new-minimally-invasive-bunion-surgery