Dr. Christine Seaworth, a fellowship-trained foot and ankle surgeon in Knoxville, Tennessee, discusses the common causes of bunions causes and treatment options to help with the pain in this patient education article.

Bunions, or hallux valgus as your doctor may say, are a deformity of the foot that usually form slowly over time near the base of the big toe. The deformity occurs as the bones next to your great toe slowly move out of alignment and are no longer straight.

Bunions can be caused by many different reasons including:

1. Genetics - Bunions that are inherited down a family line
2. Gender - More than 1/3 of women in America have bunions
3. Poor-Fitting Shoes - Women's tight high heels can make a small bunion more painful but men also will have difficulty with their dress shoes as well
4. Pregnancy - Ligaments can become laxer during pregnancy allowing bones to shift out of place

Bunions can often be very painful for a patient regardless of their size. It can become more difficult to find shoe wear that is comfortable and well-fitting. The skin may become swollen, red, and painful at the base of your big toe, and your big toe may begin to push your other smaller toes out of position. Your second toe may even cross over the big toe.

Nonoperative Treatments
Options include changes to shoe wear to make the toe box wider, deeper, and softer to give your toes more room. Also using arch support may give some relief as well as avoiding high heels. There are also many different pads made to cover the painful area and using a toe spacer may improve the position of the big toe to decrease pain.

If you would like to have X-rays to evaluate the severity of your bunion and to discuss all your options to avoid surgery, please make an appointment with Dr. Seaworth's physician assistant, Will Short P.A.-C. Will has been personally trained by Dr. Seaworth to critically assess your X-rays and discuss all of your options.

Surgical Treatments
There are many surgical options for bunion treatment. This is due to the many different causes and deformities causing bunion deformities. Surgeons will offer different surgical procedures based on what they feel will best overall treat their patient's foot problem. Most surgeons will have several ways they treat bunions and make surgical plans based on patient needs, combined with ease of recovery for the patient and improved bone and wound healing.

Dr. Seaworth personally performs three main types of bunion surgery. Sometimes bunion surgery is referred to as a bunionectomy. All surgeries work on correcting the bone alignment and rotation.

1. Minimally Invasive Bunion Surgery - This procedure only requires a few small puncture wounds and is found to have equal outcomes to traditional open bunion surgery. With this surgery, Dr. Seaworth is able to improve the bone alignment/rotation and allow much earlier weight-bearing, shoe wear, and exercise. Patients' bone and skin heal faster and they have much less stiffness than traditional bunion treatments.

2. Lapidus Bunion Correction - the Lapidus procedure is a workhorse of bunion correction for all foot and ankle orthopaedic surgeons and has been around for many years. This surgery will be recommended when you have severe deformity or also have other conditions that need to be addressed at the time of surgery including arthritis to the middle part of your foot. You may have heard about this procedure while doing research online if you have seen ads for the Lapiplasty procedure. The Lapiplasty bunionectomy is a repackaging of the old and classic Lapidus technique. The Lapidus in general requires longer periods of non-weight-bearing, a longer time for skin incisions to heal, and more big toe stiffness when this procedure is required.

3. Great Toe Fusion - this procedure is performed when patients have both arthritis and a bunion. This will realign the toe, to fix the bunion, but also make it stiff, to fix the arthritis.

University Orthoped Surgeons offers personalized foot and ankle expertise

If you're ready to discuss your bunion problem and treatment options with our specialty-trained foot and ankle surgeon, Dr. Christine Seaworth visit us at our UT Medical Center, West Knoxville, or Sevierville locations. You can request an appointment online or call (865) 546-2663 for our UT Medical Center and Sevierville offices, (865) 218-9300 for our West Knoxville office. Telemedicine appointments are also available by request.

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