Medical Questions » Feet Questions » Question No. 369
| Question: | I have two bunions on each foot on the large toes. They give me pain. Would you advise operation? If so, could I have them done at the same time? |
| Answer: | If the big toe is constantly pushed across towards the smaller toes by high-heeled shoes, tight shoes, or a poor way of walking, the big toe may become semipermanently deformed in this direction. The end of the long bone behind the two big toe bones in the front half of the foot (called a metatarsal) is exposed by the deflection of the toe bones, and starts pushing against the skin.
A protective, fluid-filled sac (called a bursa) forms between the bone end and the skin to protect the bone. This sac slowly enlarges to cause a lump that may become tender and painful. This is a bunion.
Bunions are becoming less common with more sensible and better-made footwear, and a wealthier society in which correctly fitted shoes can be purchased regularly for a child' s growing feet. Bunions usually start in childhood, but may not cause significant discomfort until adult life.
A number of surgical procedures are available to cure a bunion, but in elderly people, it may be preferable for a protective pad to be worn inside soft or specially made shoes. When bunions are repaired, it is normal for only one side to be done at a time, but in elderly people, in whom immediate mobility is not a concern, both sides can be done at once.
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