More than half the women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes. Bunions cause the base of your big toe (Metatarsophalangeal Joint) to enlarge and protrude. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe usually angles toward your second toe, or even move all the way over or under it. Just as the big toe moves toward the 2nd toe, the long bone behind the big toe or hallux, moves the opposite direction. This is important because fixing a bunion is not a simple as some think, that is, removing the “bump” is not the answer. The real problem is that the hallux or big toe is slowly dislocating off of the long bone behind it, the 1st metatarsal. To correct the bunion, usually the “bump” does not have to be removed, because it is the normal anatomical head of the bone. Instead the hallux or big toe needs to be put in the correct position, in front of the 1st metatarsal and then the 1st metatarsal needs to be moved to a correct position. That is reconstructive surgery and the correct way to repair a bunion. Recovery is usually from 3 to 6 weeks, back in shoes, but you can walk in a special boot the day after surgery. When doing the surgery, it is not necessary to have general anesthesia, as IV sedation with local anesthesia is easier and safer.

If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis. If the arthritis is severe, I can replace the painful joint with a new joint and you can often be back in shoes in 3 to 4 weeks.

If caught early, bunions can be treated without surgery with the use of orthotics. Orthotics reduce the foot from rolling off of the inside of the big toe or hallux, which is the primary cause of the bunion.