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Dr. Brandon Macy
Podiatrist - Clark, NJ
1114 Raritan Road
Clark, NJ 07066

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A bunion is a bone deformity at the base of the big toe.  While the big toe is being pushed towards the 2nd toe, the actual problem is that the 1st metatarsal bone behind the toe is unstable, causing it to shift upwards and away from the other metatarsal bones.  This will be seen as an enlargement of the inside of the foot at the base of the big toe. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes.  In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight is NOT the leading cause of bunions, but tight shoes can aggravate the condition or make for more significant pain. Bunions do tend to run in families, usually because of a faulty foot structure and the associate mechanical issues that occur as a result. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

  • Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
  • Removal of corns and calluses on the foot.
  • Changing to carefully fitted footwear designed to accommodate the bunion.
  • Orthotic devices—both prefabricated and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.  In some milder cases, the orthotics and shoe modifications alone can provide significant relief.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.  There are different procedures selected based on the specifica size and nature of the bunion.

Suregery is designed to relieve pain and correct the deformity.  A necessary part of the long term followup care involves the use of orthotics to deal with the forces that caused the bunion in the first place.  In this way, we're doing our best to keep the bunion from returning after surgery.


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1114 Raritan Road
Clark, NJ 07066

Podiatrist - Clark, Dr. Brandon Macy, 1114 Raritan Road, Clark NJ, 07066 732-382-3470