Bunions (Hallux Valgus)

How are bunions diagnosed?

Your doctor will ask you about any symptoms, in addition to your general health and medical history. He or she will also perform a careful examination of your foot while you are sitting, standing, and walking to establish a diagnosis of a bunion.

In some cases, your doctor may also order an X-ray to evaluate the extent of the misalignment of your foot bones and joints, determine whether the bunion is associated with a joint disease, or assess how severe the bunion is and how best to treat it.

How are bunions treated?

Non-surgical treatments

In most cases, bunions are managed with non-invasive interventions with a focus on relieving pain and preventing progression. These include:

• Footwear replacement. Choose shoes with roomy, broad toe boxes and heels lower than 2 inches.
• Bunion pads. Silicone pads act as a protective barrier between your shoe and the area over the bunion, helping to relieve pain or the pressure when walking. The pads can be purchased over the counter at drugstores or pharmacies.
• Orthotic devices. Shoe inserts can address alignment issues by distributing pressure evenly when you move your feet. Alternatively, you can place a spacer between your big toe and second toe. Finally, a splint that is worn at night helps keep your big toes straight and relieve pain.
• Ice application. Applying ice over the bunion helps lessen soreness and swelling, which can occur after prolonged standing or walking.
• Medications. Orally administered pills such as acetaminophen, ibuprofen, and naproxen sodium can offer relief from the pain of a bunion. Cortisone shots may also reduce swelling.

Surgical treatments

Your doctor may recommend surgery if your symptoms do not improve with other treatments, if you present with a severe bunion, or if you are not able to move a toe due to stiffness.

There are several types of surgery, and your doctor will endorse the best procedure for your situation. The types of surgery include:

• Bunionectomy. This involves the removal of some of the bone and swollen tissue from the affected joint to correct the position of the big toe.
• Osteotomy. This makes use of pins, screws, or plates to fix the bone and realign the joint.
• Arthrodesis. This procedure eradicates the swollen joint surface. Wires, plates, or screws are inserted to hold the joint together during healing.
• Exostectomy. Typically performed with an osteotomy, this procedure gets rid of the bump on the toe joint.
• Resection arthroplasty. This procedure is performed to allow more space between the toe bones by removing the damaged portion of the toe joint.