Bunions - Hallux Valgus - Clínica San Román

What are bunions or hallux valgus?

Hallux valgus, commonly known as bunion, is a structural alteration of the foot in which the big toe is displaced laterally towards the other toes, causing the formation of a bony prominence on the inner edge. This condition can generate inflammation, discomfort and favor the development of secondary deformities, such as claw or hammertoes. If you present these symptoms, our team of specialists will offer you a rigorous diagnosis and a personalized treatment, aimed at relieving pain and improving your quality of life.

How often are bunions found?

Bunions are one of the most common podiatric conditions. If you usually wear closed shoes, it is important to consider that this condition is more common in women, being 7 to 9 times higher than in men.

How long have bunions been known?

Bunions have been recognized since ancient times. One of the oldest documented cases comes from ancient Egypt, around 2100 BC, found in a mummy. It should be noted that this deformity is less common in populations that do not wear shoes on a regular basis.

Why are they called bunions?

The term “bunions” has its origin in the time of the ancient farm workers, where this deformity was frequent. Since “John” was a very common name among them, the condition came to be known as “Johns disease” or, simply, “bunions”.

Why do bunions or hallux valgus occur?

Bunions originate due to the deviation of the first metatarsal inward, accompanied by the displacement of the big toe outward.This deformity is multifactorial, as it is influenced by hereditary factors, foot morphology, prolonged use of inappropriate footwear, trauma and certain inflammatory diseases, such as rheumatoid arthritis.

What are the main causes of bunions?

Bunions are caused by the deviation of the first metatarsal inwards and the displacement of the big toe outwards. This alteration is multifactorial and is influenced by several factors, among which the following stand out:

Genetics: Up to 83% of cases have a family history.
Footwear: Prolonged use of high-heeled and narrow-toed shoes favors their development.
Type of foot: The presence of flat or valgus feet, hyperlaxity and a shortening of the first metatarsal contribute to its appearance.
Trauma: Previous injuries to the foot can trigger the deformity.
Inflammatory diseases: Conditions such as rheumatoid arthritis, gout and psoriasis increase the risk.
Occupation: Work activities that involve standing for long periods of time may favor its development.

What are the symptoms of bunions?

Symptoms of bunions include pain at the edge of the foot, swelling at the base of the big toe, redness, joint stiffness and progressive deviation of the toe.

Pain and swelling: Located on the outside of the first toe.
Bony protrusion: Appearance of a protrusion on the inner side of the foot.
Deviation of the big toe: May cause overlapping and additional deformities.
Calluses and blisters: Due to constant rubbing with footwear.
Stiffness and limitation of movement: Limitation of movement of the big toe.
Associated deformities: claw or hammertoes.

Where do bunions appear?

Bunions appear at the metatarsophalangeal joint of the first toe, commonly known as the big toe. They can also appear on the fifth toe, known as Tailor’s bunions.

Where do bunions hurt?

The pain is localized mainly in the bony protuberance and the joint of the first toe. There may be pain in the dorsal area of the foot due to pressure and rubbing with footwear .

How are bunions diagnosed?

– Physical examination: Visual evaluation of the foot.
– Anamnesis: Detailed medical history.
– X-rays: To evaluate the degree of deformity.
– Biomechanical study of the footprint: Analysis of load distribution during gait.
– Additional tests: Blood tests and vascular studies if necessary.

How to prevent bunions?

To prevent bunions, wear wide, comfortable shoes, avoid high heels and narrow toes, maintain a healthy weight, do exercises to strengthen your feet and use orthopedic insoles if necessary.

Appropriate footwear: Comfortable shoes with enough room in the front.
Orthopedic insoles: Correct the footprint.
Exercise and stretching: Strengthen the muscles of the foot.
Regular check-ups: Consult a podiatrist periodically.

What to do if I have bunions?

– Consult a specialist: To obtain an accurate diagnosis and treatment recommendations.
– Change footwear: Wear comfortable, wide shoes.
– Use braces: To relieve pain and maintain alignment of the big toe.
– Apply cold: To reduce inflammation and pain.
– Medication: Analgesics and anti-inflammatory drugs under medical supervision.

What shoes to wear?

– Comfortable and wide shoes: With enough room at the front.
– Good support: Adequate support on the back of the foot.
– Low heels: Preferably no higher than 5 cm.
– Thick sole: To cushion the impact when walking.
– Avoid excessive sandals: Limit their use to short walks in summer.

What to take for pain?

– Analgesics: Paracetamol or metamizole.
– Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen or dexquetoprofen. Always consult a physician before taking any medication.

Where to buy bunion braces?

Bunion correctors can be found in pharmacies, orthopedic specialty stores and online. Consult a podiatrist for specific recommendations.

How to correct or cure them without surgery?

– Orthopedic insoles: To stabilize the joint of the first toe.
– Physical therapy exercises: To strengthen the muscles of the foot.
– Silicone separators: To keep the toes in a more natural position.
– Use of appropriate footwear: Avoid narrow-toed shoes and high heels.

What is minimally invasive surgery?

It is an advanced technique that uses small incisions to correct foot deformity, resulting in less tissue damage and faster recovery. Realigns the bones of the foot and eliminates bony protrusion

What type of anesthesia is used for bunion surgery?

Local anesthesia is generally used, which numbs only the area of the foot where the surgery is to be performed. In some cases, light sedation may be used..

What are the benefits of minimally invasive surgery?

– Minimal postoperative pain: Less trauma to tissues.
– Rapid recovery: Patients can resume daily activities more quickly.
– Fewer complications: Less risk of infection.
– Minimal scarring: Small incisions leave less visible scars.
– Outpatient surgery: No need for hospitalization.
– High success rate: Excellent long-term results.

Who operates on bunions?

Bunion surgery should be performed by podiatrists and orthopedic surgeons specialized in foot surgery, preferably with experience in minimally invasive techniques.

When can I drive or work after minimal incision surgery?

Recovery varies depending on the patient and the complexity of the procedure. Many patients can resume daily activities within a few weeks, but full recovery may take 4 to 6 weeks.

Do operated bunions come back?

Recurrence is rare, especially if the surgery is performed properly and the patient follows postoperative recommendations, such as wearing appropriate footwear
and avoiding activities that may compromise recovery. However, in some cases, genetic and biomechanical factors may predispose to recurrence.

What kind of rehabilitation is needed after surgery?

Rehabilitation includes:
– Physiotherapy: To improve mobility and strengthen the muscles of the foot.
– Stretching exercises: To maintain flexibility of the toes.
– Use of special footwear: Post-operative shoes during the first weeks.
– Wound care: Cleaning and dressing changes according to the surgeon’s instructions.

Additional considerations

Before opting for bunion treatment, it is important to know the factors that can influence the evolution of the condition, the postoperative period and the options for long-term care. Here is some key information for optimal recovery.

Are bunions hereditary?

Yes, there is a significant genetic predisposition to the appearance of bunions. If one or both parents have bunions, their children are more likely to develop them as well.

At what age do bunions usually appear?

Bunions can appear at any age, but are more common in young and older adults. In some cases, they may develop in adolescence, especially in people with a family history of the condition.

Can men get bunions?

Yes, although bunions are more common in women, men can also develop them. The incidence is lower in men due to differences in the type of footwear and foot structure.

How do bunions affect quality of life?

Bunions can cause chronic pain, difficulty finding appropriate footwear and limitations in daily activities. Can affect mobility and quality of life, especially if not adequately treated

What complications can arise if bunions are not treated?

– Additional deformities: Such as hammertoes or claw toes.
– Arthritis: Wear and tear of the metatarsophalangeal joint.
– Chronic pain: Increased pain and inflammation.
– Mobility problems: Difficulty walking and performing daily activities.
– Infections: In case of ulcers or open wounds.

What other foot problems can be associated with bunions?

– Hammertoes: Deformity in the second, third or fourth phalanx.
– Metatarsalgia: Pain in the front part of the foot.
– Morton’s neuroma: Compression of the nerve between the toes.
– Calluses and hardness: Due to constant rubbing with footwear.
– Bursitis: Inflammation of the serous sacs in the joint.

Myths and realities

There are many erroneous beliefs about bunions and their treatment. In this section, we debunk the most common myths and clarify the facts based on medical evidence, so you can make informed decisions about your podiatric health.

Is it true that bunions only develop from wearing uncomfortable shoes?

No, although improper footwear can aggravate the condition, bunions are multifactorial. Genetic and biomechanical factors also play a crucial role in its development.

Do bunions disappear with the use of insoles?

Orthopedic insoles can relieve symptoms and prevent worsening of the deformity, but they do not eliminate bunions. Only surgery can correct the deformity definitively.

Can bunions be treated with home remedies?

Home remedies can help relieve pain and inflammation, but do not correct the deformity. It is important to consult a specialist for proper treatment.

Do all bunions need surgery?

Not all bunions require surgery. Conservative treatments, such as the use of appropriate footwear, orthopedic insoles and exercises, may be sufficient to manage symptoms in many cases.

Is bunion surgery very painful?

Bunion surgery, especially minimally invasive bunion surgery, generally causes less pain than traditional techniques. Postoperative pain is manageable with analgesics and usually decreases significantly within a few days.

Can bunions recur after surgery?

Although recurrence is uncommon, it can occur if postoperative recommendations are not followed or if there are predisposing genetic factors. It is important to wear appropriate footwear and perform rehabilitation exercises.

Conclusion

Bunions are a common condition that can significantly affect quality of life. It is essential to recognize symptoms early and seek appropriate treatment. Treatment options range from conservative measures to minimally invasive surgery, depending on the severity of the deformity and the patient’s symptoms. Consulting a podiatric specialist is crucial for an accurate diagnosis and an effective treatment plan.

Bibliography

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