Bunion Treatment


A bunion, or hallux abducto valgus, is a bump on the side of the big toe joint.  The bump is actually a deviation of the head of the 1st metatarsal away from the 2nd metatarsal bone.  As the bunion deformity progresses, there is a gradual movement of the big toe toward the 2nd toe.  In severe cases, the great toe can either lie above or below the second toe.

Patients with a bunion will usually complain of pain along their big toe when wearing certain shoes or performing physical activity, such as walking or running.  The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe.  Occasionally, corns can develop between the 1st and 2nd toe from the pressure of the toes rubbing against each other.  

Bunions are caused by an abnormal foot structure and improper biomechanics which places an undue load on the 1st metatarsal.  As the deformity increases, there is an abnormal pull of certain tendons, which leads to the drifting of the great toe toward the 2nd toe.  At this stage, there can also be arthritic changes that can occur in the joint.

What we can do to help you solve this problem

Since every bunion deformity is different, we would recommend that we see you as a patient for an evaluation.  We will perform a thorough history and physical examination.  We will perform a complete biomechanical evaluation to see how this may contribute to the formation of the bunion deformity.  We will obtain digital x-rays to fully assess your bone structure.

Some bunions respond to conservative treatment.  If you have a mild deformity, we initially may recommend symptomatic relief for a bunion. Switching to a shoe with a rounder, deeper toe box may often provide relief.  The use of a pad or cushion over the bunion deformity or between the first and second toe may also be helpful in reducing pressure and providing some basic relief.

If not too advanced, we sometimes will recommend prescription orthotics to help prevent the progression of the bunion deformity. Custom orthotics can treat mild bunion deformities and prevent the problem from worsening by controlling abnormal pronation and stabilizing the first metatarsal.

When conservative measures fail to provide adequate relief, however, surgical correction of the bunion deformity is usually indicated.  The choice of surgical procedures (bunionectomy) is based on a biomechanical and radiographic examination of the foot.  Because there is often bone displacement and joint adaptation, simply removing the bump is often inadequate in providing long-term relief of symptoms.

The most common surgery for the correction of a bunion deformity is an Austin bunionectomy.  This is a procedure in which the 1st metatarsal head is cut and moved to the correct position.  


Some bunions may require a procedure to be performed at the base of the metatarsal to fully stabilize and prevent the deformity from returning.  A Lapidus bunionectomy is a procedure that we do frequently to accomplish this.


If you are having pain with your bunion, we would recommend that we see you for a professional evaluation.  The physicians at Council Bluffs Foot & Ankle Care are experts in the management of bunion deformities.  We can help you find the best solution for your foot.  Call or text us to make an appointment today! 

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