A bunion is an enlargement of bone or tissue around the base of the big toe. The bone forces the big toe inward toward the second toe, which results in pain, redness and swelling in the joint. If a bunion grows large enough, it can interfere with everyday activities and make walking or prolonged standing difficult or impossible.
Causes and Risk Factors
Although genetics is not believed to be a factor in developing bunions, an inherited foot structure (for example, flat feet) or a way of walking may increase the risk of developing bunions. Other causes include:
- Stress or injury to the foot
- Nerve conditions that affect the foot
- Rheumatoid arthritis
- Improper footwear such as ill-fitting, high-heeled or pointy-toed shoes that crowd the toes
A visual examination is all that may be required to diagnose a bunion, although magnetic resonance imaging (MRI) and/or X-rays are used to determine the extent of the deformity. The results of an X-ray and MRI can help determine the approach required to treat the bunion most effectively.
When conservative remedies no longer provide the relief, a bunionectomy to remove the bunion and re-align the big toe may be necessary. As with any surgical procedure, bunionectomies carry risks and provide no guarantee of complete relief so it is important to discuss your expectations with your surgeon.
Usually, an X-ray is taken to determine the exact structure of the big and second toes. Most bunionectomies can be performed under local or general anesthesia as an outpatient procedure by a foot and ankle surgeon. Patients will need someone to drive them home after the procedure.
Patients are released to go home usually the same day. Someone must drive the patient home. The foot is covered with a boot or cast of some type to protect the surgical site and provide foot stability. Total recovery from the surgery may take two months or more and some patients require physical therapy to recover foot mobility and range of motion.