Wednesday, November 2, 2011

That Bump on Your Big Toe

                                                   That Bump on Your Big Toe

As we age, our bodies change in many ways. Suddenly bumps we have had for many years begin to change, or hurt. For example, the bony lump on the outer side of your big toe, which presses against the inner side of your shoe, begins to hurt when you wear your favorite shoes. That bump is likely a common disorder, known as a bunion. For many people, a bunion is somewhat unsightly but nothing more. For others, though, it can also be very painful.

First Steps in Treatment
When a patient comes to our office with a bunion, we initially recommend a foot x-ray to confirm the bunion with its abnormal angle at the big toe. The first thing we do to help patients is to modify their shoes because the pain is often the result of the bunion making the foot wider than the shoe. We recommend a wider shoe or weather permitting, open for the toes. Proper shoes for treating bunions also have a built-in arch and minimal to no high heels. We may also recommend padding to cushion the bunion as well as orthotics, which are custom-made shoe inserts.

Pain Killers Help
Over-the-counter anti-inflammation medications, such as aspirin, ibuprofen, and naproxen can help to ease inflammation and pain caused by the bunion. A cold-pack application is also helpful. Some patients ice the bunion for 10 minutes each evening.
To reduce tension on the inner part of the joint of a bunion, we may also prescribe stretching exercises.

When These Efforts Fail
It is only when the non-surgical options do not help a patient’s pain that a surgical treatment is considered. Performed to both relieve pain and restore normal alignment to the big toe joint, this surgery is an outpatient procedure. The surgery usually involves shaving part of the bulging bone (the head of the metatarsal) and straightening the direction of the big toe. We may also tighten the ligaments on the outside of the toe and loosen the ligaments on the inside to correct the tension and keep the toe pointing in the proper direction. During recovery, the patient wears a soft surgical-type shoe.

Board Certified in Orthopaedic Surgery, Jamal Ahmad, M.D. received a medical degree from the University of Illinois at Chicago. He completed an orthopaedic surgical residency at the State University of New York and a fellowship in orthopaedic foot and ankle surgery at Thomas Jefferson University Hospital. He is a member of several national societies including the American Academy of Orthopaedic Surgeons and the American Orthopaedic Foot and Ankle Society.  Dr. Ahmad is an Orthopaedic Surgeon  on the medical staff at Riddle Hospital.


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