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Hi Jessica - I'm sorry to hear that you're dealing with painful bunions, especially at such a young age. I'm impressed by the fact that you're seeking information so that you can be fully prepared when you next see your podiatrist, and you've asked some great questions.

First, some basics. A bunion is a thickened lump at the base of the big toe. It causes the big toe to move toward the smaller toes and makes walking difficult. Bunions are caused by a deformity of the metatarsophalangeal (MTP) joint at the base of the big toe. This causes instability of the joint. The deformity can be caused by:

* Flat feet, which transfer too much weight to the MTP joint
* Narrow-toed shoes and high heels
* Certain neuromuscular diseases ( Down and Marfan syndromes)
* Activities that put undue stress on the feet, such as ballet

There are several ways bunions can be treated, including, as you mentioned, surgery.
The goals of treatment are to relieve pressure on the bunion and stop progression of the deformity. Types of treatment include:

Padding and Taping

Padding the bunion reduces pain and allows you to continue a normal, active life.

Taping helps to keep the foot in a normal position, reducing stress and pain.


* Anti-inflammatory drugs (ibuprofen, naproxen) to ease pain and inflammation
* Cortisone injections to ease pain and inflammation

Proper Footwear

Wear shoes that are wide and deep in the toe area. Make sure the top of the shoe doesn't hit or rub against the bunion. There should be one-half inch of space between the shoe and the end of your longest toe when you are standing up.
Physical Therapy

Physical therapy can relieve inflammation and pain. Ultrasound therapy is often used for treating bunions and the related soft tissue problems.


Shoe inserts may be useful in maintaining foot function. They are thought to reduce symptoms and prevent worsening of the deformity.

Have you tried all of the treatments listed above? Surgery may be needed to relieve the pressure and repair the toe joint, if the other treatments fail. I would ask your podiatrist if he/she feels you are a good candidate for surgery and about the specific procedure involved. Surgical procedures include removal of the bony lump
as well as more involved procedure that includes cutting the bone and realigning the joint.

As to whether to have surgery one at a time or two at a time, that decision is largely dependent on your lifestyle and how each option would affect you. What do you think would be best?

Here are a couple of resources that can provide additional information about bunions, treatments and surgery.

American Orthopaedic Foot and Ankle Society

American Podiatric Medical Association

Here are links on EmpowHER that provide information and address some of your questions:

You will likely have more questions after you review this information, so please come back and share them. We welcome ALL of your questions and are happy to help.

Take good care,

February 24, 2010 - 6:58pm


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