Bunions, a knobbly problem

 June 2011

Summer is here and we all love wearing flip flops and open toed sandals. But all this can be spoilt by the common problem of a bunion.

Bunion is one of those medical terms, like gout, that most of us have heard of but few realise what a real problem it can be until they suffer from it.

A bunion, or its proper name hallux valgus, is usually on the joint of the big toes and appears as a large red bump, hard and red. It can be very painful, especially when under pressure from shoes, and can also cause stiffness and difficulty in walking.

Bunions are more common in women than men and they are more likely to appear as we get older.

A bunion really is a deformity, when the angle of the big toe moves inwards towards the little toe from the top and the long bone (technically the 1st metatarsal) moves away from the little toe. This forms an exaggerated angle in the joint which causes the stress and pain.

Bunions are often inherited and can sometimes be caused from injury or rheumatoid arthritis. They can be aggravated by poor fitting shoes.

When bunions are not particularly big or causing too much discomfort, they can be left alone. However, in many cases they are so painful and cause so many problems with walking and obtaining shoes that can be worn in comfort that surgery is the recommended treatment.

Bunion surgery today is very successful and recovery can be quick. There are a number of different procedures that can be used, all with the main purpose of realigning the big toe back into its natural position and to eliminate the bump on the side of the toe joint. An incision is made on the side of the big toe joint and the metatarsal will be set into a better position, usually fixed into place either by a small pin or screw while the bone heals. The surgeon will usually shave off the bone on the side of the big toe joint to make the foot straight again and in some cases, the ligaments and tendons may need to be repositioned.

The operation usually takes around half an hour and is a often done under local anaesthesia so that the patient can go home quickly. The foot is stitched back and bandaged and sometimes a plaster cast is used to protect the foot while the bone heals.

The risk of complications after surgery are low but can include infection, nerve damage or even a recurrence of the bunion.

After the operation, the foot will require continued support and protection as the bone heals and pain killers may be needed for a while. Specific exercises will also be recommended and recovery can be anything from a few weeks to even months depending on how intrusive the surgery was and your general level of health.