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Bunions

What are Bunions

Bunions are also called Hallux Valgus which is the anatomical way of saying your toe is deviating away from the midline of your body.  Bunions can develop from an inherited bony structural defect in your foot or can develop over time due to flat feet or excessive pronation.  They can also develop due to an anatomical leg length discrepancy and will usually be found on the side of the longer leg.

What are causes and Symptoms:

If the big toe is allowed to be irritated over time a bulging, bony and painful bump will form and be noticeably red.  You may also develop restricted movement in the joint in addition to the pain.  Some patients report that the pain seems to come and go and is not persistent.  For this reason many allow the injury to progress which can result in permanent damage to the 1st toe joint or can even result in a transfer injury to the 2-3rd toe joints.  These transfer injuries are common due to the person consciously or subconsciously shifting their weight away from the 1st toe joint onto the 2-4th toe joints.  Common injuries resulting from this weight transfer are metatarsalgia, capsulitis and plantar plate tears.

How to diagnose it?

Diagnosis requires nothing more than visual inspection but an x-ray may be taken to see the extent of the damage to the joint itself.

Treatments:

Most patients are trying to avoid bunion surgery so we will only discuss conservative treatments.  Shoes with a wide toe box such as the brand Altra will prevent excessive friction and pressure.  There are taping protocols to help tape the big toe into proper alignment as well as braces that are meant to accomplish the same.  Custom orthotics can be made to help take stress off the bunion and help with pain free walking and running.  Lastly foot manipulation is possible to adjust the joints of the feet and promote alignment.

Recommendations:

  1. Custom orthotics to take pressure away from the bunion, decrease pain and prevent worsening of the condition.
  2. Shoes or sandals with a wide toe box
  3. Taping the toe or bracing it into better alignment
  4. Manual manipulation of the foot joints to promote better alignment

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