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By Glenn G. Gabisan, MD, FACS

 

A bunion is a prominence at the inner aspect of the big toe or hallux. Bunions are a common cause of foot pain especially in closed-toed shoes.

The prominence is caused by an increased angulation of the hallux. There may be an inherited genetic predisposition to the development of bunions, which can be exacerbated by tight closed shoes. Bunion deformities may or may not progress. Bunion pain is usually caused by external pressure from tight shoes.

Wearing shoes with a wide soft toe box or open sandals frequently relieve pain. Leather shoes may be stretched over the bunion. Toe spacers, braces, and stretching exercises may help pain but do not change the bunion deformity.

If pain persists despite using accommodative footwear then surgery may be helpful. Radiographs with weight bearing help determine what surgical procedure is indicated. Bunion correction may require cutting and repositioning bones with a corrective osteotomy. A postoperative shoe or boot is worn for six to eight weeks. Postoperative swelling usually subsides over three to six months.

As you explore surgical options, beware of so-called "minimal procedures," which are often inadequate leading to high chance of recurrence. Surgery is intended to relieve pain by correcting the deformity and should not be performed only for cosmesis.