Patients often come into the office reporting that they have bunion growing like a “golf ball” by the great toe. While it is true that there is spurring that is happening around the joint at the later stages of bunion development the circular ball like bone, we are feeling through the skin did not grow out but moved out.

What are bunions and why do we get them? The diagnosis is called hallux abductovalgus deformity (HAV) which explains that the great toe moves away from the center of the body and the first metatarsal, the long bone behind the great toe rotates. This rotation causes the joint at the base of the great toe to dislocate moving the circular head of the metatarsal and creating an illusion of a “ball” that gets larger as the deformity becomes more severe and the joint continues to dislocate.

The type of dislocation and joint destruction will all depend on the biomechanics of the foot. Both nature and nurture contribute to development of bunion deformities. Looking at your grandparents and parents’ feet, you may recognize late stages of the deformities that you are beginning to face as alignment of the bones and flexibility of the joints that we are born with will largely determine the fate.

Does this mean that there is nothing we can do to stop the deformity and progression? We can slow the process and avoid much of the pain by wearing the proper shoes for the foot type and if necessary, getting custom foot orthotics. Consulting your local podiatrist and working with a pedorthist can educate you and provide you with the conservative treatment as well as medical devices to realign the biomechanics and slow the progression of the bunion deformity.

If the conservative treatment fails, the appropriate surgical procedure for the deformity can be discussed and considered. The extent of the deformity evaluated on x-rays as well as patient’s life style contributes to the decision-making process.

You don’t have to live with discomfort and pain and with conservative or surgical intervention there is a treatment option available to get you back to what you love to do.