What is a Bunion?  

A bunion is often described as a bump on the side of the big toe.  However, a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straightahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Causes

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people may never have symptoms. Bunions are a common foot deformity that can be inherited or occur as a result of repeated stress to the joint.  It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Not wearing proper sized footwear that crowd one’s toes will not cause bunions, however it can contribute to the progression of the deformity. As a result, symptoms may appear sooner with improper footwear.

Symptoms

Symptoms, which occur at the site of the bunion, may include:

• Pain or soreness

• Inflammation and redness

• A burning sensation

• Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Diagnosis

Bunions are readily apparent – the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.

Non-Surgical Treatment

Most people however, find relief from wearing soft, pliable shoes, and arch supports, and from applying ice to the sore toe joint Sometimes observation of the bunion is all that’s needed. To reduce the chance of damage to the joint, periodic evaluation and x-rays by your surgeon are advised.

Dr. Young Talks About Lateral Column Pain and Lateral Overload

This is a subject that I have talked about previously. I wanted to revisit this and summarize this problem and condition. The lateral column of the foot encompasses the fourth and fifth metatarsals. This is the outside of the foot that includes the fifth toe and the fifth metatarsal phalangeal joint. It also includes the fifth metatarsal base which is the insertion point for the peroneal brevis tendon. Finally it also includes the cuboid bone and some patients with this may be diagnosed with "cuboid syndrome".

This is a common condition that I see in our clinic. It is frustrating for our patients because often this is not something that comes with a real nice clear diagnosis like let's say a bunion. But what happens is the patient will present to our clinic and say that they have pain on the outside of their foot (lateral column). Often times the patient will have a high arch foot or they will have compensated for another problem such that the weight is shifted to the outside of the foot. The lateral column is not designed for significant weightbearing. This is primarily the function and job for the great toe joint and the medial column. Therefore all it takes is a small change in weightbearing or the pattern of gait and the extra load going through the outside of the foot causes pain and symptoms. It is very rare to have a stress fracture in this location but that can happen. What can happen as there is just fatigue and pain on the lateral column and the stress load is such that it is short of that needed to cause a stress fracture. So stress fracture rarely occurs in this location. It is possible to develop pain at the insertion of the peroneal tendon of the fifth metatarsal base. It's also possible to have a tailor's bunion and have that pain flareup.

Our patients will have an x-ray to make certain there is no other pathology in this location. This condition responds very well to prescription orthotics tuned to shift the pressure off the lateral column of the foot, especially if it is a chronic condition. Some athletic shoes are better than others for this also. If there is a component of peroneal tendon symptoms, and there is a special ankle brace that may be helpful also.

These are some the conditions that may be associated with lateral column pain:

-Tailor's bunion or pain affecting the fifth MTP joint

-Stress fracture of the fourth or fifth metatarsal (rare)

-Stress reaction of bone of the fourth and fifth metatarsal (rare)

-Nonspecific Bone "fatigue and pain" of the fourth and fifth metatarsal (common)

-Insertional peroneal brevis tendinitis

-Cuboid area pain "cuboid syndrome"

If you have foot pain and need evaluation, please see myself Dr. Timothy Young, or my partner Dr. Brendon Nelson. Give us a call at 425-391-866 or make an appointment online. 

Issaquah Foot and Ankle Specialists has been performing bunion surgery for more than 20 years and have performed thousands of bunionectomies. Having performed so many bunion procedures has allowed us to perfect our skills and provide patients with the most up-to-date bunion procedures. Currently there are almost 50 different bunion procedures that can be performed. However, the majority of these procedures are divided into 3 categories;

1. fusion or arthrodesis

2. head procedures

3. base procedures

It is important to note that not everyone is a candidate for one of these procedures. I can tell you it is important to have the entire foot structure evaluated as well as having x-rays done. I continue to get a lot of second opinions in my office due to the fact that I do perform so many bunionectomies. I do really enjoy discussing bunions and bunion procedures with patients in providing him with answers further questions and help with their feet. If you’re suffering from a bunion and are contemplating conservative care or surgical care consider making an appointment with us today.

It is that time a year again to use your medical benefits/HSA/FSA and get a new set of prescription custom orthotics to keep your feet healthy.

What are prescription custom orthotics?

These are custom medical appliances  that were traditionally made from a cast of your foot. We are now using the latest technology that records three dimensional images of your feet. Your foot is placed in its best functional position and then scanned using the scanner pictured to the right. The images are used as a form to make the prescription custom orthotics. The doctor completes a unique prescription, depending upon your specific problem and foot type. From this, the prescription custom orthotics fits inside of your shoe to change and improve the biomechanics of your gait. Prescription custom orthotics may be prescribed for a variety of specific applications including running shoes, soccer shoes and ski boots. They fit your feet perfectly!

Issaquah Foot & Ankle Specialists

425-391-8666

Bestfootdoc.com

Bunion Before & After Pictures