In order to help you better understand what factors go into causing and making your bunion hurt, I'm going to use the skeleton and demonstrate for you how these mechanical foot problems affect your bunion.
The first thing to note in the normal model is that the toe is relatively straight or head. When you come into the office with your bunion, you've already seen a bump on the side of your foot. But the question is what's underneath that bunion. When we look at that, both through my clinical exam as well as through x-ray, what we find is that your big toe is going over more toward the second toe and your first metatarsal separates from the second. When that happens even without growing any bone here, you can see that a bump will start to show on the side of this joint.
Next is that the whole first segment here, including your great toe and the metatarsal behind it often become excessively mobile. And as this happens greater and greater separation occurs between the first and second metatarsals. The toe begins to drift over. In the hand, if we didn't have this mobility, you wouldn't be able to touch your thumb to your little finger. But when we do that, look what I've created a bump on the side which is very similar to the bunion in your foot. And unless you're going to use your foot to write with a pencil, you don't need that hypermobility.
What Causes Hypermobility in Bunion Formation?
So where does that hypermobility come from? Why does the foot start to drift over like this? What happened here during your life that wasn't there when you were a youngster? And that answer often comes from examining the rest of the mechanics of the foot. And many times we see the flexible flatfoot or tendency to go excessively in that direction associated with the development of bunion.
Once we determine the extent of that problem, I can help decide whether conservative measures such as providing support on the side of your foot with shoes, over-the-counter supports and orthotics will help, or whether the problem has progressed to the point where surgical intervention is necessary.
So before you return for another visit, I want you to answer these questions for yourself.
- Has your bunion pain become worse over the last six months?
- Is your bunion discomfort present consistently throughout your day?
- Has your bunion discomfort forced you to limit the activities that you wish to pursue.
Once you answer these questions, and think about the presentation you've received today, we can plan the next step for resolving your bunion pain.