NYC’s Most Highly Rated, Award Winning and Board Certified Podiatrist Says: Here’s what you should be asking yourself.
A bunion is a painful bump on the side of the big toe. It is considered a structural deformity that involves the first metatarsal. When the big toe rotates sideways towards the second toe, the first metatarsal shifts in the opposite direction, changing the angle of the bones. Once the bunion forms, it will worsen over time and gradually become more prominent. Learn more about Bunions on our Gotham Footcare blog.
Bunions will worsen over time if not properly managed. Some symptoms include:
If you are experiencing the above symptoms, it is best to seek care to alleviate your pain and to help you return to your normal activities.
Bunions can form for many reasons, such as:
A bunion’s appearance and symptoms can worsen over time because of improper shoe gear. Women are ten times more likely than men to develop bunions because of shoes that do not fit properly. Often, the shoes are too tight or narrow in the toe area, which forces the big toe inward and exerts pressure on the first metatarsal.
Conservative care can slow down the progression of a bunion and should always be attempted first.
However, the continuous wearing of improper fitting shoes such as high heels or shoes with poor arch support will cause your bunions to become more severe. Eventually, a mild bunion deformity progresses into a moderate or severely sized bunion. Only surgical correction can permanently stop a mild bunion’s progression into a moderate deformity.
Patients seek bunion treatment for the following reasons:
Your care is our top priority.
Depending on the severity of the bunion, a correction occurs with a variety or combination of different methods involving bone shaving, bone cutting to realign and fixate the bone into its anatomically correct position, and/or bone mending by fusing the bone at the joint. At Gotham Footcare, your doctor will have an in-depth discussion with you regarding which procedure will best accommodate your individual needs and expected outcomes.
At Gotham Footcare, your doctor will begin by asking you several questions to better understand the subjective nature of your bunion deformity.
Your doctor may ask you questions about when you first noticed your bunion and how quickly your bunion has progressed. Your doctor will want to know the following:
In addition, you may also be asked about the kind of shoes you usually wear and whether you have a job that requires you to be on your feet for long periods.
A thorough physical examination of your bunion deformity is performed to examine your great toe for changes in its bone structure and alignment of the great toe joint. The motion of your great toe is assessed to determine if your bunion restricts the normal range of motion or causes pain, numbness, or tingling in your toe or foot. Your doctor will perform a gait assessment by asking you to walk a few steps to see how your body weight is distributed across your foot and toes.
An X-ray of your foot is taken to assess the severity of your bunion and help determine the most appropriate method of surgical correction if necessary. This X-ray will help your doctor visualize how far the great toe joint has moved away from your other toes, if arthritis is present, and if any other bones in the foot or toes have been affected.
Non-surgical approaches for bunions will help decrease the pain, the forming of calluses, and aid in limiting the progression of the bunion growing more severe.
Non-surgical options include:
Properly Fitted Shoes
Comfortable shoes must provide the proper support for your foot and offer a wide toe box.
Bunion pads, bunion splints, or toe spacers
It’s important for the pressure and irritation in your shoes to be reduced. Bunion Pads, bunion splints, and toe spacers offer a reduction in pain and stress on your toes and help to realign the big toe while slowing down the progression of the bunion.
Custom Foot Orthotics
An orthotic device customized to the exact shape and size of the foot to better support and align the great toe with easing current discomfort and preventing future progression.
Icing can help reduce inflammation and alleviate discomfort.
Strong anti-inflammatory medications can be injected to decrease pain and swelling directly at the bunion region.
Exercise and other physical therapy treatments can help reduce pain and inflammation, strengthen poorly functioning muscles, and stretch tight muscles that may be exacerbating the bunion.
Topical and oral prescription-strength medications can decrease pain and inflammation.
Modification of Activities
Reduction of high impact and/or pain-inducing activities may help reduce symptoms.
Not all bunions require surgery. The proper treatment for your bunion depends on the severity of pain, medical history, how rapidly the bunion has progressed, and if pain relief is achieved with conservative non-surgical treatments. Our doctors will work with you to find the best solution that delivers optimal results.
When conservative treatment fails, surgery is recommended to help correct the misalignment of the great toe joint.
Depending on the severity of the bunion, a correction occurs with a variety or combination of different methods. These methods involve bone shaving, bone cutting to realign and fixate the bone into its anatomically correct position, and/or bone mending by fusing the bone at the joint. Regardless of the incisional approach, the gold standard correction for bunions is to cut, realign, and fixate the bone into its anatomically correct position. There are two main methods to realign your misaligned bones. One approach is to create an osteotomy (bone cut). The second approach is mending (fusing a joint).
At Gotham Footcare, the doctors favor traditional realignment of the bone; however, we understand the importance of minimal scarring.
The surgeons are trained to implement plastic surgery techniques to ensure that the incisions heal invisibly. Our surgeons perform bunion surgery to the highest standard, with minimal scarring for the most optimal, functional, and aesthetic results possible. There are three types of cosmetic incisions for bunion surgery:
Minimally Invasive Incisions(s)
Bunion surgery for minor bunion deformities can be attempted utilizing a minimally invasive bunion approach by making a small incision to either shave down the prominent bone or break and fixate the bone into its correct position with screws through another small incision. Your surgeon uses tactile senses and real-time intraoperative x-ray to visualize the bone cutting, realignment, and stabilization of bony segments.
Plastic Surgery Incision
Unique surgical techniques are applied to incisions on the foot to limit scarring and for a more aesthetic result. Our surgeons use deep sutures to secure the skin together and run a thin absorbable suture within the superficial layers of your skin, which keeps the skin tightly closed. The incision is as minimally visible as possible.
At Gotham Footcare, our surgeons strategically place the incision along the demarcation line where the skin on the top of the foot meets the skin on the bottom of the foot. This approach makes the incision not visible when looking down at the foot.
Bone healing takes a minimum of six to eight weeks in healthy individuals. Patients often return to their normal activities and shoe gear within six weeks to three months. Healing may be prolonged for the following factors:
Walking after bunion surgery is strongly dependent on the surgical procedure and method of fixation used to correct the bunion deformity. At Gotham Footcare, our advanced techniques and protocols allow nearly all patients to bear weight immediately in a stiff-soled cam walker without casts or crutches after surgery.
At Gotham Footcare,
your doctor will show examples of before and after pictures and x-rays, and have a thorough and in-depth discussion with you regarding which procedure will best accommodate your individual needs and expected outcomes. Your feet are the foundation of your body; they are responsible for locomotion, balance, posture, and supporting the weight of your entire body. Yes, it is important to have pretty feet, but it is even more important to have pretty feet that function properly.
At Gotham Footcare in NYC, we strive to provide you with the education you need to make well-informed decisions regarding your care. Regardless of what your bunion condition may be, at Gotham Footcare, our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward. Schedule your consultation today.
Bunion surgery is performed in our outpatient surgery facility conveniently located in our office downtown, therefore you can go home the same day. During your surgery, your foot is numbed with an anesthetic. Your anesthesiologist provides a sedation known as ‘twilight sleep.’ You will be monitored with local and regional blocks of anesthesia care.
In most cases, the answer is yes and much more comfortable than before surgery. With bunion surgery, the width of the foot is reduced as the great toe joint is aligned, which will also allow for greater motion of the toe.
Bones take six to eight weeks to heal after surgery, allowing most patients to return to regular shoes in six weeks and resume more aggressive exercising at the 12-week point. Due to advanced hardware and improved surgical techniques, bunion correction is an effective way to alleviate pain associated with bunions and allow you to return to your extracurricular activities within a relatively short period of time.
Bunion surgery is a minimally invasive surgery, and as with all surgeries, there is always some risk, but complications are rare.
At Gotham Footcare in NYC, we strive at recognizing your individual needs and desired outcomes while formulating an effective and personalized treatment plan with the highest quality care available.
What sets Gotham Footcare apart from other podiatry offices is our dedication to providing you with the education you need to make well-informed decisions regarding your care. Regardless of what your foot and ankle trouble may be, at Gotham Footcare our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward.