Bunions, a deformity of the big toe, affect women far more often than men. Ninety percent of bunion sufferers are female. About half of all women have bunions, the American Academy of Orthopaedic Surgeons, or AAOS, reports. Bunions can occur because of inherited foot tendencies, foot injuries or congenital deformities, but the most common cause is footwear that's too tight, MayoClinic.com says. Treatments range from the simple, such as lifestyle changes, to surgical options.
Considerations
When bunions first develop, they may cause few symptoms and need no treatment outside of a possible change in footwear. Over time, however, the bunion becomes increasingly painful and also more deformed, making wearing regular shoes difficult. The toe bones shift, with the upper bone leaning in toward the second toe. This makes the "bump" on the side of the toe more prominent. When the bunion interferes with normal activities, surgery may be considered.
Non-Invasive Treatments
The first treatment for bunions is to change shoes. Medical personnel can also tape and pad the foot in a more normal position to reduce stress. Custom-made shoe inserts called orthotics help realign the foot for people with foot deformities or issues that worsen bunions. Over-the-counter inserts may help somewhat but rarely provide the relief custom inserts do, MayoClinic.com reports. Anti-inflammatory medications can reduce inflammation at the site and decrease pain. Cortisone injections reduce inflammation and pain but can't be used too frequently. Icing the area helps reduce pain and inflammation, and decreasing activity also allows the toe to heal.
Surgical Treatments
Surgical treatments for bunions vary, depending on what's out of alignment in the foot. If the muscles and tendons are too tight on one side and too loose on the other, pulling the bone out of alignment, the abnormalities can be surgically corrected. An osteotomy cuts and realigns the joint. Arthrodesis, removal of the damaged areas and pinning together with screws or pins until healing occurs, may be used for severe bunions. Arthroplasty, which removes the damaged part of the joint, creates a flexible joint from the scar tissue, the AAOS says.
Surgical Procedure
Bunion surgery, usually done on an outpatient basis, takes about one hour and is normally done under an ankle block. General anesthesia or spinal anesthesia may also be used. A special show or casts protects the foot and keeps it in proper position for the first six to eight weeks. Using a walker or crutches keeps weight off the foot during healing.
Treatment Complications
Fewer than 10 percent of people experience complications after bunion surgery, the AAOS reports. About 10 percent to 15 percent of people experience some continued tenderness in the scar, the Foot and Ankle Clinic reports, while slow healing or infection occur in 1 percent to 2 percent. Hallux varus, deviation of the big toe away from the body of the foot, occurs in 1 percent of cases and may require further surgery.
