On Your Toes

Those shoes may match the outfit, but are they good for your feet?

One of the most common foot ailments that I see walk though my door are bunions,” explains board-certified podiatric surgeon Robert P. Dunne, DPM. A bunion is an unnatural, bony hump that forms at the base of the big toe where it attaches to the foot. Often, the big toe deviates toward the other toes.Those shoes may match the outfit, but are they good for your feet?

“Sometimes, this particular foot deformity is genetic; other times, it can be related to an injury to the foot or a congenital issue [a deformity present at birth],” explains Dr. Dunne. “Arthritis can play a role, along with improperly fitting shoes and high heels.” 

Bunion Symptoms

There are several symptoms to look for when diagnosing bunions.

“A bulging bump could be evident at the base of the big toe,” describes Dr. Dunne. “There may also be some swelling, redness and soreness in the area of the big toe’s joint. Other signs include a thickening of the skin at the base of the big toe, limitation in movement, pain that comes and goes, and corns and calluses developing.”

According to Dr. Dunne, people are intimidated by treatment for bunions because they have heard negative stories regarding surgical correction. “Our patients come first, and we recommend they take action now if they have a problem. Surgery is not the only option. Alternate treatments are available.”

When to See a Doctor?

“More often than not, a patient will put off treatment until surgical correction is the only option,” says Dr. Dunne. Here are some of the signs that you should be aware of:

Difficulty with movement of the big toe

A bump at the side of your big toe

Issues with shoes fitting properly

Big toe pain that is constant or intermittent

The formation of corns or calluses

Redness in the area at the bottom of the big toe

Once you make an appointment with your doctor, it is helpful to know what questions to ask, including “What is the cause of my foot pain, and is this a long-term or short-term problem?” This is another question to ask: “Is surgery right for me, or is there a conservative treatment that will help?”  These are useful questions to help you make decisions about your care.

“Occasionally, a bunion formation left untreated can cause additional ailments to arise,” warns Dr. Dunne. “These can include bursitis, hammertoe formations and metatarsalgia, which is pain and inflammation in the ball of the foot.”

Treatment Options

“For a bunion, our typical treatment regimen will be determined by the severity of the deformity, along with the individual needs of the patient,” explains Dr. Dunne.

“Again, surgery is not always the only treatment option a patient has. Treatment should be tailored to the patient’s needs.” 

Some conservative treatments include:

The application of ice

Orthotics (over-the-counter or custom-molded)

Medications to reduce inflammation

Padding and splinting of the area

Changes to better-fitting or more appropriate shoes

Rehabilitation time varies per patient and type of surgical procedure. As always, the patient’s individual needs come first, and treatment should reflect those needs.

Lake Washington Foot & Ankle is a comprehensive podiatric medicine clinic, offering treatment for everything from ankle sprains to hammertoes.

“We treat ingrown toenails, warts, dermatitis, ankle and heel pain, tendonitis and neuromas,” assures Dr. Dunne. “We also do clinical trials for onychomycosis [fungal toenails], as well as studies on diabetic ulcers, in an effort to find better and more effective treatments for these and other ailments.”

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