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Do Bunions Need Surgery?

Overview
Bunions
A foot bunion is a common cause of foot pain caused by deformity of one of the toe bones. They most commonly affect the big toe, known as hallux abducto valgus, but can also affect the little toe, known as a bunionette. The classic presentation is a large bump on the outer side of the big toe that is red, swollen and painful caused by the toe deviating across towards the second toe. Left untreated, the condition usually gets gradually worse, so it is important to get treatment early on else you may end up needing bunion surgery.


Causes
Bunions are not inherited, but do tend to run in families. What is inherited is the poor or faulty foot type, that mechanically can lead to the instability around the joint that will eventually lead to bunions, how soon, how quickly and how bad they are or become is assumed to be very dependant on the footwear. A number of other factors are known to play a role in the cause of bunions and hallux valgus. Bunions can follow foot injuries and develop in those with neuromuscular problems. Those with flat feet or pronated feet appear to be more prone to the instability about the joint and have a higher incidence of bunions. Some activities (eg ballet dancing) puts added pressure on the joint and may increase the chance of bunions developing.


Symptoms
The symptoms of hallux valgus usually center on the bunion. The bunion is painful. The severe hallux valgus deformity is also distressing to many and becomes a cosmetic problem. Finding appropriate shoe wear can become difficult, especially for women who want to be fashionable but have difficulty tolerating fashionable shoe wear. Finally, increasing deformity begins to displace the second toe upward and may create a situation where the second toe is constantly rubbing on the shoe.


Diagnosis
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.


Non Surgical Treatment
There is no way to eliminate existing bunions except to have them surgically removed. There are nonsurgical measures you can take to alleviate the pain and prevent your bunions from increasing in severity, and for that reason it’s important to see your doctor before they become a serious problem. The more extensive your bunions are, the less effective nonsurgical treatments are. On the other hand, most bunions can be dealt with without surgery through wearing roomier, low-heel shoes, padding and taping your feet, using medications for pain control, going to physical therapy to relieve inflammation and wearing orthotics in your shoes to correct mechanical problems. Bunions that are not causing pain generally aren’t appropriate for surgery. Roomier shoes. You should seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed. You should make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe. Make sure the ball of your foot fits comfortably in the widest part of the shoe. Feet normally swell during the course of the day, so shop for shoes at the end of the day, when your feet are at their largest. Don’t be vain about your shoe size, sizes vary by brand, so concentrate on making certain your shoes are comfortable. Remember that your two feet are very likely to be different sizes and fit your shoe size to the larger foot. Low-heel shoes. High heels shift all your body weight onto your toes, increasing the pressure on your toes and their joints tremendously. Instead, wear shoes with low (less than two inches) or flat heels that fit your foot comfortably. Padding and Taping. Padding the bunion can minimize pain and allow you to walk more normally. Specially designed pads for this are available at most drugstores. Taping your foot can reduce stress and pain in it by helping it stay in a more normal position. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with pain and inflammation caused by your bunion. Cortisone injections may be prescribed for the same purpose. If your bunion is a consequence of arthritis in the MTP joint, your physician may prescribe medications for that. Physical Therapy. Ultrasound treatments and whirlpool baths can help reduce pain and inflammation in bunions and related tissues. Orthotics are shoe inserts that can help correct mechanical foot-motion problems to reduce pain and prevent worsening of your bunion. Other measures. Icing and elevating your foot when your bunion is painful may help. Having your shoes stretched at a shoe repair shop may help also.
Bunions Hard Skin


Surgical Treatment
If non-surgical treatments have failed to relieve your bunion pain, or when the pain is interfering with your daily activities, contact the Dallas bunion surgery specialists at North Texas Foot & Ankle to discuss surgical options. There are a several ways to perform bunion surgery. The best procedure for one person is not necessarily the best for another. Some procedures allow you to walk much sooner, reducing the need for crutches. Depending on your foot type, the procedure can have a greater risk for return of the bunion deformity. Other procedures may require you to be on crutches for a few weeks - but could offer a better result in the long-term. Learn more about the different types of bunion surgery.


Prevention
Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. Medicine will not prevent or cure bunions.

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