Many individuals have asked me, somewhat rhetorically “do I have a bunion?” Maybe you do, and maybe you have more than just a bunion.
A bunion is technically a bump, and this term is frequently used to describe a bump on either the big toe side or the little toe side of the foot.
Bunions are not always problematic and do not always require treatment by a trained professional. Sometimes altering the type of shoe that you wear can accommodate the bump and fast forward you to comfortable function and activity. If this works for you, it may be all you need to do, at least for a while.
A trained professional, however, will take a closer look at your foot type, and may recommend a supportive over the counter or custom insole to control excessive motion while walking, standing and running, if this motion is either causing or accelerating the development of the bunion.
Other individuals, however, may have more going on, and that is when your big toe is moving toward the second toe and creating what we surgeons call hallux valgus. The hallux is fancy-talk for big-toe, and the term “valgus”, which is the opposite of “varus”, is the lateral angulation toward the smaller toes.
If the bone just behind the hallux, the “1st Metatarsal” is angled inward, or in varus, you probably have “Hallux Valgus, Primus Varus and Bunion” and may or may not need surgery, depending on the degree of angulation, deformity, dysfunction and limitation of your “ADL’s” (Activities of Daily Living).
Bunion surgery is usually performed in an outpatient facility and is typically done with local anesthesia and intravenous sedation. We also sometimes call this type of anesthesia “monitored anesthesia care”; blissful sleep, conscious sedation, or a light general, depending on how much medication is required to keep you comfortable during the procedure which typically takes less than an hour to complete. You will wake up feeling fresh, and of course, almost always completely pain free thanks to the modern combination of medications and techniques that we use in our practice.
Realignment of the angles of your bones is just as important as smoothing off your bump. Every operation is carefully planned and tailor made to match your truly unique situation and foot type. We use modern, ultra-light and low profile hardware that almost always stays in permanently and does not typically require removal.
Recovery is active and takes approximately 4-8 weeks, depending on the technique that you require. Almost all patients can walk immediately after the surgery in a special surgical boot or shoe, and can return to a modified exercise routine in just a few days.
The goal of surgery is elimination of pain, deformity and instability, and to allow you to wear normal shoes as well as function at a higher level.
Victor V. Cachia DPM, Founder and Director, Aloha Foot and Ankle Associates, Inc.