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A classic bunion (hallux abductovalgus or HAV) is a bony protrusion on the side of the big toe joint. The bump represents abnormal movements of the joints just below the ankle joint. As the front portion of the foot spreads, the big toe drifts towards the second toe and the long bone by the big toe pushes outward. The development of bunions is strongly hereditary. Most patients think bunions are caused by shoes, but bunions actually develop from excessive weakness in the bone structure of the foot causing the joints to move out of proper alignment. Improperly fitted shoes will aggravate the condition and contribute to the development of a more significant deformity. Common daily activities, such as walking and running, become a painful experience.

Treatment ranges from very conservative methods to surgical intervention, and decisions are made depending on pain tolerance, the patient's lifestyle, and the extent of the bunion. X-rays are taken to define the deformity. Initially, wider shoes may be recommended to alleviate any pressure on the bunion joint. Pain management can include cortisone injections or anti-inflammatory medications while a more decisive course of treatment is being determined.

Orthotics are generally recommended to reduce and slow down the progression of the bunion. When conservative measures fail to provide relief, the patient is given various surgical options, including removing the bony protrusion on the side of the first long bone of the foot (metatarsal) and cutting the bone to normalize the alignment. As a bunion worsens, the joint in the big toe can become stiff and arthritic, and joint replacement may be required. In both cases, hardware such as pins, screws, and wires are used to hold the bone in place during the healing process. Dr. Toback will discuss your specific needs and determine which course of surgical intervention will produce a successful result.

Foot Tip:

Have your feet examined by a podiatrist today in order to evaluate the bone structure of your feet. Early detection and proper preventive foot care can prevent painful foot problems in the future.

CORNS AND CALLUSES

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Corns and calluses represent areas of excessive pressure or friction from shoes or hard walking surfaces. Calluses are areas of thickened, tough skin generally found on the bottom of the foot. Corns are the rough, thickened skin irritations found on the tops and sides of the toes, very often the little toe, and are generally associated with the hammertoe deformity. Most patients do not realize that corns are not a skin related problem. Corns are the direct result of a bone abnormality, and therefore over-the-counter corn removal pads will never correct the problem. Instead, corn pads cause more damage to the tender skin and increase the risk of infection to the area.

Cotton or foam cushions offer temporary pressure relief. Extreme caution should be used when using over-the-counter corn and callus removal pads, as they contain acid that burns through the thickened skin to remove it. Diabetics should NEVER use an over-the-counter corn or callus pad (See Diabetics). Surgical removal of the deviated bone is the preferred treatment. The most common remedy is simply trimming down or buffing the thickened area and utilizing foam and padding cushion inserts.

Foot Tip:

Never use over-the-counter corn and callus removers, as they burn and damage the skin. Seek podiatric treatment to correct the bone deformity as soon as possible.

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