Healing That Painful Bunion!

Dr. John B. Perry DPM, FACFAS, Atlantic Foot & Ankle Center, P.A.

Hallux Valgus..... Bunion.
These are medical terms for an angled great toe and painful joint.

What is it?
Bunions are not hereditary, although the tendency to over pronate (flatten your arch) which is a cause of bunions, has a hereditary component.

The capsule of the great toe joint is deviated, thickened and enlarged, and the cartilage of the joint is damaged. There are three degrees of bunions: mild moderate and severe. Typically the great toe joint is involved, but the fifth toe joint is also called a bunion or bunionette.

What are the common symptoms or complaints?
Both sites can be angled and painful. You will often have difficulty fitting into shoes.You try wider and wider shoes but to no avail. The pain persists, often with every step.You may try a gel pad or a bunion shield. These devices offer some temporary relief. Still your foot hurts when you walk or run. Standing in dress shoes kills after just minutes! It’s time for a professional evaluation. Call your doctor and get a referral to a specialist, a podiatrist, someone who specializes in treating and correcting disorders of the foot and ankle.

What can I expect on my first visit?
Generally, a thorough history is taken to determine the factors aggravating the big toe joint. Is there any history of arthritis, gout or trauma? Has the angulation been there long and only recently gotten painful? Do bunions run in your family?

Next, it’s common to take precise weight bearing xrays. Often the doctor can tell the amount of joint deviation and joint damage from these x-rays. Possibly, your podiatrist will prescribe some pain relievers or nsaids, temporary inserts or pads to alleviate your pain. In some instances you may need cortisone shot to lessen the inflammation.

What about foot inserts or custom orthotics?
Custom molded inserts are a great way to control the over rolling (pronation) of the foot and ankle. These devices can be manufactured to fit into shallow dress shoes or deeper sports shoe. This treatment is the next logical step if the temporary pads and gels provide some relief.

What if these treatments don’t provide the relief I need?
In that case the next step is usually surgical planning. Your Podiatrist will work with your primary care doctor to provide an exam and simple blood test to clear you for surgery. In the majority of cases the surgery is same day ambulatory surgery. You will go into the hospital for a few hours 3-5 have your surgery and go home the same day. An ice pack, pain meds and elevation for a few days are necessary to limit swelling and speed your recovery.

Your doctor and staff will prepare you and assist you to plan the best times and treatments to get you back on you feet quickly. Newer techniques involve the fixation of your bone, after the bunion correction, to align the angled joint and allow quick weight bearing and rehab.

If your bunion hurts and a change in shoe gear or use of over-the-counter treatments with pads, have provided little to no relief, then call you doctor for an evaluation. Ask for an evaluation and x-ray. The first visit is painless, covered by most insurances and can get you on the road to recovery and eliminate your painful bunion deformity. Relief is just a call away!

Dr Perry trained at Harvard Medical School/Cambridge Hospital and worked in the ski industry for years before becoming a podiatrist. He specializes in the biomechanics of the lower extremities. He lives in North Yarmouth Maine with his wife and four children, whom he actively coaches in sports.


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