Bunions are often looked at as just a cosmetic concern however this is not true.  They can cause pain and discomfort and lead to more foot problems in the future.  Today I will discuss bunions, what they are, their cause, symptoms and what we can do to treat them.

What is a bunion?

A bunion is a bony protrusion of the 1^st metatarsal.  It occurs as the 1^st metatarsal shifts out of place and the big toe begins to drift towards the second.  This begins as a small misalignment of the joint and grows larger and more malaligned as time and mileage increase. 

Causes of bunions:

There are many causes of bunions and from long term research we know the following are the most common. 

-Genetics plays a large role in the development of a bunion.  You inherit your foot structure and this can predispose you to a bunion. 

-Another source cited is footwear.  Anything that puts more forefoot pressure like a high heeled shoe can accelerate bunion formation. 

-Systemic causes can be attributed to bunions.  Conditions like Rheumatoid arthritis or other arthropathies that attack joints. 

Symptoms:

These are what usually bring patients into the office.  These are things like having a hard time fitting shoes, rubbing the big toe on the 2^nd toe.  Another common symptom is pain or swelling and redness of the big toe joint. 

Treatment:

I usually break the treatment up to conservative and surgical.  The conservative measures include, no bare feet and wearing a wider shoe.  Save your money no splints or stretching devices of the big toe work.  Remember this is a bony malalignment and you can not move bones from the outside of your foot.  Surgery is the only long term fix.  The surgical correction depends on the size, age and overall foot structure. 

If you have a bunion and would like a consultation I can help.  Please call 425-391-8666 or make an appointment online, and ask for an appointment with Dr Nelson.

Sincerely,

Brandon Nelson

Double Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

Bunions are one of the most common reasons people schedule an appointment with a foot and ankle surgeon.  It is by far the most common surgical procedure I do.  People of all ages and activity levels can have a bunion.  The primary reason people schedule an appointment is difficulty fitting the shoes they would like to wear.

I think there are quite a few reasons to fix your bunions these days and I will discuss a few of the most beneficial reasons.

1.     Foot Structure

Bunions are an inherited foot disorder and are more common in women.  They are usually the result of a foot that wants to flatten out too much or what we would call pronate.  A bunion results when the first metatarsal tries to stabilize the medial arch.  This results in the first metatarsal moving out of place and the bunion developing.  Fixing a bunion can result in stabilization of the medial arch.  This can have effects on the overall stability of the foot.  I see patients that have had plantar fasciitis or other stability issues that resolve once the bunion is fixed. 

 

2.     Shoe Fit

Another big issue with bunions becomes an inability to fit in normal shoes.  I see a lot of wide shoes and short extra depth shoes when people try to accommodate bunions and other toe deformities.  It is often a relief to be able to have shoes fit again and get back to wearing the shoes you once enjoyed or liked after your toe is straightened. 

 

3.     Your Bunion Will Get Larger

Many people believe they can use straps or tape or toe straighteners and change their bunion.  However, we know from long term data this is not true.  There is no way to reverse your bunion without surgery.  Everyone’s bunion with time and mileage will get bigger.  I recommend having it fixed before it causes the 2^nd toe to become a hammer toe or begins to cross over or under the 2^nd toe.

If you have a bunion and want an evaluation schedule an appointment with me, or make an appointment online, I will help you. 

Sincerely,

Brandon Nelson

Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

Bunions are present in many different sizes and shapes.  I see bunions on the inside of the foot, the outside of the foot and both.  It is important to remember that some small ones can be painful, and some large ones can be pain free.  It often seems to be dependent upon activity levels and shoe gear.  If they hurt or limit your lifestyle then maybe it is time to fix them. 

Fixing your bunion

Bunion surgery has two main procedures that are done.  One is what is called a head procedure.  This is basically cutting the bone and realigning it through transposition of the bone.  Usually fixated with one or two screws.  The other involves fusion of a joint, specifically the joint that is involved with the creation of the bunion.  This procedure is called a Lapidus bunionectomy. 

Bunion recovery

Recovery really depends on the procedure that is performed.  Head procedures recover faster and usually involve no periods of non-weight bearing.  The fusions often involve a period of crutches or knee scooters.  This can be as short as 3 weeks or as long as 10 weeks.  The weight bearing status can be dictated by other procedures that are done as well. 

Which bunion surgery is right for me?

This is a hard question to answer.  I believe this is where your consultation with your surgeon is extremely important.  Other factors like lifestyle, recovery support, expectations and experience can play a major role.  I think it is important to get an entire overview of the process and have a discussion with your surgeon.   

If you would like a consultation for your bunion I can help.  Call to make an appointment with me at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

People with a painful bunion often begin to contemplate bunion surgery. Bunion surgery is a great option for patients who are wish to relieve symptoms cause by bunions.

There are many different types of bunion surgeries. Bunion surgeries are based on the size of the bunion and the individual foot structure. The majority of bunion surgeries require and incision on the top of the big toe joint. The procedure then involves removing and realigning bone and soft tissue of the big toe joint. If any other foot issues are present, like a flatfoot, these should be fixed at the same time.

Scheduling an appointment to have your bunion evaluated is the first step. Dr. Nelson will discuss your x-rays and all of your options. He will present both conservative and surgical and help you determine what is best. Some common questions include:

-Surgery is done one foot at a time

-The majority of bunion surgeries are less than 2 hrs

-Patients are sedated during the procedure and this is done in the office

-Pain medication will be prescribed for when the nerve block wears off

-Walking without crutches is possible for most people

The recovery can vary from patient to patient. However, most people can bear weight after the procedure. It is important to follow all post-op instructions carefully. If you have a painful bunion and want to know what options are available and live in Issaquah, Sammamish, Snoqualmie, Bellevue, Seattle, Kirkland or Maple Valley give us a call so we can help.

Give us a call today at 425-391-8666 or make an appointment online. 

Bunions can be quite painful and difficult to manage. Most patients experience pain along with the bunion itself. However quite a few patients can have foot pains in other locations secondary to the bunion. We see a lot of patients that have strapping, bracing and using shoe gear accommodations all to no avail. These are hard modalities to maintain and do not do anything to correct the bunion deformity. The only long-term solution to fix of bunion is surgical. However there are some other options that can alleviate the pain and slow the progression of the deformity.

The surgical procedures available for bunion correction usually can be characterized as a head or base procedures. Head procedures are done at the metatarsal head or towards the toes. Base procedures are done at the base of the metatarsal towards the metatarsal cuneiform joint. The type of procedure that is best for the bunion itself is correlated with a radiographic examination and physical examination foot, the other factors to consider are lifestyles and age of the patient. I recommend anybody evaluating bunion surgery to make an appointment to be evaluated and make sure you have the best possible outcome.

The most common surgical procedure I perform by far is a bunionectomy. The bunionectomy procedure itself can be very rewarding for patients and physicians like. Often times patients come in with a significant amount of foot pain and a history of multiple conservative modalities have been attempted all to no avail. These people are obviously good candidates for surgical correction. Additionally I see a lot of patients that are currently not in pain however have a hard time fitting shoe gear or have a large bunion a family history of bunion deformities.

Surgical intervention is often warranted for patients that have a family history of bunion deformities or have a hard time fitting in shoes. A few patients come in with a large bunion that doesn’t have pain. Initially it is important to evaluate the patient from a clinical standpoint and radiographic standpoint. Often times on the x-ray we’ll see the beginning of arthritis and correcting the bony can help reduce the chance of long-term arthritic changes. I recommend patients that have a bunion to release be evaluated. That way we can at least implement conservative measures. 

Bunions or even tailor's bunions can be extremely painful and difficult to find fitted shoe gear. There is a definite genetic component to the development of bunions themselves. In addition we see certain shoe gear or activities can increase can increase the size of bunions. Anything that puts increased forefoot pressure creates increased force to the bunions themselves. I often times will recommend a course of conservative care for people that have not tried these options for their bunions.

At our clinic, we created a special protocol for bunion patients and have extremely successful options for conservative bunion care. There are many great stretching and strengthening exercises for the foot structure. In addition there is a plethora of options including prescription orthotics that our clinic specializes in to control the development of the bunion. In addition we have many different options for bunions that are starting to produce pain and arthritic deformities of the foot. Our clinic takes the latest scientific research in conjunction with years of experience to maximize the outcome of conservative bunion options. If you continue to suffer from bunion pain and wanted to explore conservative options, give us a call at 425-391-8666 or schedule an appointment online.

Bunion surgery provides great outcomes for patients that want relief from foot pain. Foot pain associated with a bunion can be very difficult to manage from a conservative standpoint. A lot of patients have tried getting bigger or wider shoes, which can create more room for the bunion to grow and make the situation worse. Patients will also apply pads, straps, splints or tape to the feet. This can be time consuming and cumbersome and again does nothing to fix or reverse the cause of bunions. The only way to actually fix the bunion is surgically. Bunion surgery has come a long way there are now new techniques we utilize to decrease down times and post-operative pain.

New techniques offer shorter recoveries and quicker returns to activity. Pain control can be challenging for both patients and physicians that are not as familiar as we are with modern techniques and medications. We use a long acting anesthetic to make the foot numb and prescribe different medications based on each individual patient and procedure performed. We have taken years to perfect our pain control regime and find the majority of our patient’s rate their pain as being well controlled. If you are contemplating bunion surgery come see us. With our pain control regime, onsite surgical center and years of experience this will create the best possible experience for you.

If you have bunion pain, give us a call today at 425-391-8666 or make an appointment online.

Some patients begin to notice a bump that is developing on the inside of their foot. They start to get pain with walking and exercise and they wonder what is happening. Often a patient will visit the shoe store or seek advice from nonmedical personnel as to what it is. It is important when been dealing with medical issues to seek the advice of someone who has had years of training and experience in that particular field. Your foot and ankle health is essential for long-term well-being of your overall general health. Bunions are the most common cause of pain and irritation around the big toe joint. The bunion is a bony deformity that often appears as a protuberance around the joint.

The majority of bunion deformities are an inherited foot structure. Patients can often trace to other relatives that have similar foot conditions. The pathology itself continues to progress with time and there is no conservative measures that reduce or correct the deformity. It is important to understand that conservative measures can sometimes help alleviate pain and increase overall functional performance. However, the bunion can only be fixed surgically. The surgical procedures depend on the patient’s overall foot structure, degree of deformity and activity levels. All bunion deformities that require surgical correction are done in the office and no longer require any hospitalization. All bunion procedures that we perform at Issaquah Foot and Ankle Specialists allow patients to be weight bearing and do not require prolonged periods using crutches or knee scooters. If you have a bunion deformity and would like to have it evaluated for either conservative or surgical measures please give us a call at 425-391-8666 or make an appointment online today.