The bunion, scientifically known as Hallux Valgus, is the most common foot deformity, being a very frequent reason for medical consultation.
What is a bunion?
By way of explanation, it is the appearance of a lump in the medial part of the forefoot, combined with the deviation of the first toe towards the rest of them. This results in a deformity, since the toes are being pushed.
The myth that it is the bone itself that grows and creates the deformity is totally false. The reality is that it occurs because of the deviation of the first metatarsal, causing a deviation in the tendons that reach the tip of the first toe, deflecting it in the direction of the other toes.
Why do some people suffer pain and others do not?
First of all, the bunion as a deformity does not hurt. The pain that the patient feels is due to the activation of the nociceptive receptors, that is, when the nerves send pain information to the brain due to an external cause. When the bunion grows, the bone is deflecting and pushing, generating an inflammation that will send the information to the brain as pain.
A different case is when the cause is footwear that compresses the forefoot laterally. The foot can widen when we have a bunion, causing the shoe to squeeze and irritate the tissues around the deformity, sending this information to the brain. For these reasons, it is common for some patients to stop feeling pain after a while, when the deformity stops increasing and comfortable shoes are used.
What is the origin of the bunion?
The patients are not to blame for the bunion, nor the footwear they have been wearing for some time. Bad habits can increase the symptomatology (pain) but it is not the only cause.
The origin of the pathology is related to our genetics and environmental conditions (activity and footwear), as well as chance. What is true is that the elasticity of the tissues favors its appearance, and it is for this reason that it is more common in women, since they tend to have more elastic tissues.
Is it recommended to operate the bunions?
We must be clear that the bunion is not a malignant disease, it is a mechanical problem, so in no case is it mandatory to operate.
On the other hand, in order to perform a surgical intervention we must evaluate two concepts:
- Pain.
- The presence of large deformities that do not allow the introduction of any footwear or that cause wounds in the skin.
In these cases, surgery can be assessed with the advice of a specialist in traumatology. It should be kept in mind that intervention is not recommended as a preventive measure, since it cannot be known whether the deformity will continue to progress. Age is not a limitation either, since the results can be just as effective.
Is the surgery painful?
It is not a painful surgery. It is an outpatient procedure and, in many cases, the patient does not require painkillers during the postoperative period, or very little.
After the operation, rest and elevation of the foot is recommended to improve circulation, but it is possible to support it. After one month, normal life can be resumed.
What are the results of orthotics?
In many occasions they are uncomfortable and it is not demonstrated that they correct or prevent deformities. The only certainty is that they keep the finger in the correct position and, in some cases, can relieve pain.