Why You Shouldn't Ignore That Bunion Pain? Your Feet Will Thank You Later.

Bunion Surgery Specialists in NYC | Manhattan

Dr. Miguel Cunha answers the most asked questions about bunions. 



Q. What are bunions and what typically causes them? 

A Bunion is a structural deformity involving the first metatarsal, causing a painful bump on the side of the forefoot near the great toe.  Bunions form when the big toe rotates sideways towards the second toe. The first metatarsal shifts in the opposite direction, gradually changing the angle of the bones that make up the great toe joint. This produces the characteristic bump, which increases prominently over the years. 

Bunions are caused by nature, as they are genetically inherited and can progress more rapidly over time because of nurture, such as the use of improper shoe gear.  Women are 10 times more likely than men to develop bunions because women are more likely to wear narrow, tight, and pointed-toe shoes that force the big toe inward, and place increased pressure on the first metatarsal. 


Q. What can be done to treat a bunion?  At what point is bunion surgery necessary?

Surgery is the only way to correct a bunion, however not all bunions require surgery.  The best treatment for bunions depends on the severity of pain, medical history, how rapidly the bunion has progressed, and if pain relief can be achieved with conservative non-surgical treatment.  Mild symptoms can be addressed conservatively by wearing more comfortable shoes and using custom orthotics, padding and/or splints to support your toe in a more normal position.  Topical medications, icing, and stretching exercises can also help alleviate symptoms of pain and suffering.  When conservative treatment fails, surgery is recommended to help correct the misalignment of the great toe joint.   


Q. What could happen if you do not treat your bunion? 

Overtime, bunions can worsen in appearance and symptoms.  Poorly fitting shoes such as heels or shoes that lack proper arch support, can cause bunions to become more prominent in severity and to progress more rapidly over time.  If left untreated a bunion can further cause athritis and/or the cartilage in the joint to deteriorate. A progressive bunion will require a bigger surgery.  Also, keep in mind that a bunion can be corrected with surgery, but athritis and the possibility of chronic pain are not curable.  Therefore, it's my recommendation that a bunion is corrected earlier than later.


Q. What type of job or activities is most bothersome to someone with a bunion? 

Bunions are especially bothersome to people whose jobs involve a lot of standing and walking such as nursing, teaching, and serving in restaurants.  Exercising, and especially running and dancing, with bunions can be a painful experience.


Q.  Can running make a bunion worse or lead to more discomfort? 

Bunions occur because of a biomechanical imbalance involving the first metatarsal and can progress more rapidly in feet that are flat and overpronate.  Walking or running in shoes that lack proper arch support can lead to overpronation, which can in turn contribute to an increased imbalance and structural deformity of the great toe joint.     


Q. Which sneakers do you recommend for someone with a bunion?

For those suffering from bunions, I recommend the following shoes:

These all offer the following desirable features:

Q.  Can you evaluate a bunion through a virtual appointment?


During the pandemic I had many online appointments to initially discuss the possibility of a bunion surgery.  A bunion is a visible condition however after discussing the condition and the spectrum of options ranging from conservative care to surgery, I always recommend that my patients come in to take some x-rays.  X-rays are done on-site.  This way I can better evaluate the severity of the bunion, the proper care as well as the right bunion technique if that is the desired path.  A bunion surgery will significantly reduce or eliminate pain altogether as well as provide a more aesthetically pleasing foot appearance.  Keep in mind, that there are many types of bunion surgery techniques.  Your surgeon will go through each one that range from minimally invasive, to gold standard methods that will prevent the bunion from returning.  

Dr. Miguel Cunha Dr. Miguel Cunha, Board Certified Surgical Podiatrist, founder of Gotham Footcare, and leading podiatrist in Manhattan is a highly trained and skilled foot and ankle surgeon with experience treating a wide array of foot and ankle conditions from minor problems to complex reconstructive foot and ankle surgery. Dr. Cunha takes pride in having a genuine interest in each and every one of his patients while providing them the utmost compassion and exceptional care.

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