Bunions - Dr. Jeffrey E McAlister



A bunion, also known as “hallux valgus,”is a painful bony bump that forms at the big toe joint on the inside of the foot. Bunions are known to develop slowly. Over time, they increasingly cause more pain and difficulty walking or wearing shoes. Bunions form at the metatarsophalangeal joint (MTP) joint, where the two bones that make up the big toe, called the phalanx and metatarsal meet. It is estimated that approximately 50% of adults suffer from bunions. Not only can adults be affected by bunions, but children can as well, especially girls between the ages of 10 and 15 years old.

Symptoms, Causes or Risk Factors, and Treatments of Bunions

Symptoms of Bunions

In addition to the bony bump that may visibly be seen forming on the big toe, other symptoms of a bunion may include:

    • Pain and soreness
    • Redness and inflammation
    • Presence of corns or a callus
    • Stiffness and limited range of motion of the big toe, which may cause difficulty walking
    • Numbness or burning sensation

Causes or Risk Factors for Bunions

The bone structure that causes bunions to grow is thought to be inherited. However, there are other risk factors that may cause bunions to develop, such as:

      • Wearing poorly fitted, tight shoes – The big culprits are shoes that are narrow and have a sharply pointed-toe and/or high-heel structures. In fact, bunions are more commonly seen in adult women instead of men, as women tend to wear shoes that put their toes in less natural positions.
      • Overpronation – Having a low arch or flat foot, which creates instability of the toe and foot joints and can lead to a bunion forming.
      • Inflammatory conditions – Different types of arthritis, such as rheumatoid arthritis can cause bunions.
      • Foot injuries – Injuries to the foot may cause bunions to form because of the related trauma to the bones about the big toe.
      • Nerve & muscle conditions – This cause of bunions is less common. An example would be a bunion associated with having polio.

Treatment Options for Bunions

Non-Surgical Treatment Options

There are several non-surgical options to treat bunions.

      • Well-Fitted Shoes – One way to prevent and treat bunions is to wear properly fitted shoes that have a wide toe box. This will eliminate the amount of pressure put on both the toe and foot.
      • Pain Medications – Additionally, over-the-counter pain-relieving medications, such as ibuprofen, may be used to reduce the pain and swelling associated with bunions.
      • Injection Therapy – Cortisone injections are another treatment option that may be used. These are especially helpful in reducing inflammation for patients.
      • Orthotic Inserts – These inserts are placed directly in the shoe and aid in keeping the big toe in a correct, straight position, which may relieve a patient’s pain. Splints may also be worn at night and utilized for the same purpose. Another relatively inexpensive treatment option are “Bunion Shields,” which are protective pads that work to cushion the painful bunion area. These can be purchased at a local drugstore or pharmacy.
      • Icing – This is a quick, easy treatment method. Applying ice several times a day for a 20-minute duration can help reduce swelling. Note, however, ice should not be applied directly to the skin.

Surgical Treatment Options

If the previously discussed non-surgical options have been exhausted, surgical treatment may be considered. The most common surgical operations for bunions, which depend on the severity, may include:

      • Metatarsal Osteotomy – A corrective surgery performed to realign the great toe joint, which typically can be done in a minimally invasive fashion.
      • Midfoot Arthrodesis (Fusion) – Performed for severe bunion cases with a non-arthritic great toe joint.
      • Great Toe Arthrodesis – A highly successful procedure for severely arthritic bunions and revision cases or failed bunionectomies.
      • Osteotomy – A corrective surgery that consists of cutting or removing a piece of bone.
      • Tendon and Ligament Repair – This typically involves lengthening the toe and removing any weak joint tissues. This surgery is frequently done in combination with an Osteotomy.
      • Exostectomy – Surgical removal of the bony bump on the MTP joint. This operation is typically performed in conjunction with an Osteotomy.
      • Arthrodesis – Involves the removal of the swollen joint surface. This treatment option is generally used for patients who have a severe bunion, suffer from arthritis, and for whom previous bunion surgical procedures have not worked.

Advanced Bunion Surgery Techniques & Technology:
Committed to offering the most advanced surgical options, Dr. McAlister uses leading technology for bunion surgery:

Lapiplasty 3D Bunion Correction – This technology provides advanced ability to support the surgeon in correcting all three dimensions of the bunion deformity at the root of the problem to restore the natural anatomy of the foot. With a faster recovery, most patients can walk within days after surgery using this technology.

Minimally Invasive Bunion Surgery – A technique that leading foot and ankle surgeons are trained it, including Dr. McAlister. This bunion surgery technique reduces trauma to the foot, decreases pain and increases recovery over traditional bunion surgery.

If you are suffering from bunions, there are many treatment options available to you. Dr. McAlister can work collaboratively with you to determine the best treatment plan for you.

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