Dr. Roger Mann has been a pioneer in the treatment of bunions. He has popularized what is now the most commonly performed bunion procedure, known as the “proximal crescentic osteotomy.” In this procedure, the metatarsal bone is cut in a curved shape at the base of the metatarsal bone (toward the middle part of the foot). Cutting the bone in this shape allows for the bone to be precisely repositioned to straighten out the toe. Not only will wearing a comfortable, well-fitting shoes prevent bunions but they will aid in the prevention of many other foot problems. Take care of your feet. They keep you on solid ground.
Surgery to correct the underlying bone deformity may be indicated for bunions that do not respond to conservative treatment. Surgery is recommended if a bunion causes severe pain or if there is neuritis/nerve entrapment, the great toe overlaps/underlaps the second toe, or ulceration is present. Contraindications to surgery include active infection and extensive peripheral vascular disease. Always stand when trying on shoes to make sure they still fit comfortably when the foot expands under your body weight. Do not cramp the larger foot. Try shoes on both feet, and select the size appropriate for your larger foot. Use an extra insole if one shoe is looser than the other.
The gold standard in treating flatfoot is orthotic therapy. Orthoses are custom made shoe inserts that assist in foot function. Since the orthoses are custom made, they are design to address the child’s specific foot structure and associated problems. These devices will help prevent the flatfoot from progressing and decrease the current pain that the child is experiencing. Surgery is a treatment of last resort. In rare cases, a child will continue to have pain or disabling fatigue after all conservative treatments are attempted. Surgery is invasive and often unnecessary to control flatfoot pain, so it is not attempted until the doctor and parent have exhausted all other treatment options.
Try easing the pain by massaging your foot in a vertical motion. Compression of heating pads on regular intervals provides great help to your feet. Injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located in a joint) sometimes seen with bunions. When you start to have joint pain or the bunion condition limits your activities and all conservative options have failed, surgery may be necessary. Joint pain may indicate degeneration of the joint cartilage. One of the goals in surgery is to realign the joint to prevent further loss of joint cartilage. Bunion surgery allows for realignment of the joint.
Poses in which you balance on one leg, such as ardha chandrasana (half-moon pose), are the most challenging. They can be extraordinarily difficult for people with bunions, especially because of the tendency for the knee to lock and the arch to collapse from the bunion. The bunion makes the foot very unstable and wobbly, since the bones of the foot are unable to stabilize, and thus we often lock the knee to stabilize the posture—and avoid the needed work in the foot. Instead of succumbing to this habit, practice keeping a microbend in your knee and lift your toes to shift your weight back onto the heel.
Another surgical treatment may include fusions of the first metatarsophalangeal joint ( MTP joint ) by arthrodesis and removal of the joint and replace it with a prosthesis ( arthroplasty ) Bunionectomy / exostectomy that involve removal of the medial body prominence of the MTP joint are performed. Osteotomy and realignments can also be performed as well as Lapidus procedure which involves a fusion that is performed at / near the first metatarsophalangeal joint (MTP joint). Manipulation of the soft tissue is also performed to alter the function and structure of the tendons and ligaments.
Bunions are officially called hallux valgus in medical language. The word “hallux” refers to the big toe, and bunions are a foot condition where the big toe doesn’t line up straight with all the other toes. The joint where the big toe meets the bones of the foot, called the first metatarso-phalangeal joint, should form a straight line with the entire big toe and the metatarsal or long bone of the foot. In a bunion , the big toe starts moving in towards the other toes. There may be some rotation in the first metatarso-phalangeal joint when this happens as well.
The Pilates Method is a great training program to benefit foot-care. Because exercises are done barefoot, the feet have a chance to work and develop the subtle muscles that help support the arches. The first exercises done on the Pilates Reformer in a typical workout are for footwork. Joseph Pilates even created two foot specific pieces of equipment – the Foot Corrector, and Toe Tens meter. He understood the value and benefit of focusing on the feet and incorporated many foot health exercises into the Pilates system. The congruence of the MTP joint is assessed. No lateral subluxation detected of the proximal phalanx on the metatarsal head indicates congruent joint.
There is a strong genetic component that contributes to the formation of bunions. More specifically, this means that there are mechanical foot traits that are inherited and that can result in the tendency of bunion formations. With a genetically disposed foot type, overtime, adaptive changes of the bones and joints will occur, leading to a bunion. Statistically, there is an increase of bunion formation in women as well as patients that wear constricting shoes. The combination of the genetic and external factors increases the risks of bunion formation. Put a piece of foam or cotton between the affected toes to see if it eases the pain or pressure.