‘My foot is killing me!”This is a phrase uttered daily by many people, especially women, due to painful bunions and hammertoes. Most put off medical care for these conditions, as they are either unaware of newer options, or because they have heard that treatment, especially surgery, is often complicated and painful. However, this is no longer true since new treatment approaches and surgical techniques allow for a fewer complications, less pain, and faster recovery. Pain-free feet in summer sandals can still be a reality!
A bunion — Hallux Abducto Valgus – is a bump at the inner side of the foot at the big toe joint. Hammertoes are contractures of the smaller toes, and the condition is often associated with a corn, callous or bunion.A hammertoe, or claw toe, describes a condition where the toe(s) become buckled, contracted or crooked.Any of the toes may be affected, but the 2nd and 5th toe are most commonly involved.
Bunions and hammertoes are progressive throughout life.They can be present from early teen years through any age. Heredity and shoe choices are the most likely reasons to develop a hammertoe or bunion. Factors such as weight and activity level can also affect the development of these deformities. However, pes planus (flat feet) deformity has been primarily linked to being the primary causative deformity that leads to bunions and hammertoes.
Patients with a hammertoe may develop pain on the top of the toe, tip of the toe, and/or on the ball of the foot. The toe may become irritated, red, warm and swollen.The pain may be dull and mild, or severe and sharp. Pain is often made worse by shoes, especially shoes that crowd the toes.
There are various conservative methods of treating bunions and hammertoes. Wearing a more accommodative pair of shoes can help, though this is not practical for everyone. Pads placed over the area of the deformity may help minimize pain. Splinting devices might assist temporarily. Orthotic devices can be used to slow or prevent the progression of a bunion. Also, anti-inflammatory medications and injection therapy are a sure way to alleviate the pain and swelling associated with a bunion or hammertoe. However, none of these treatments can actually reverse a bunion deformity. Since bunions are a bony structural problem, the most definitive treatment is surgery. People, however, often postpone surgery due to misconceptions, such as, extreme pain, slow healing and visible scarring.
In fact, with newer surgical approaches and postoperative management, patients often experience very little pain after the first 48 hours. Today’s more modern techniques utilize smaller incisions and less extensive soft tissue dissection which in turn, minimizes pain and healing time. Most patients find that the initial postoperative discomfort is tolerable with a dedicated pain management program that includes pain medications. Today, the majority of patients having distal bunionectomies such as the popular Austin bunionectomy, and nearly all hammertoe surgery can be weight bearing immediately after surgery in a protective walking boot due to recent technological advancements. Usually, the patient can wear sneakers in three weeks and return to all activities by six weeks. However, those patients that undergo bunionectomies at the base of the first metatarsal, such as a base wedge bunionectomy or a Lapidus bunionectomy, may need to remain non-weight bearing for up to six weeks. Patients often return to desk jobs in two weeks, while those working in physically demanding jobs may have to wait longer.
Ultimately, each patient should be evaluated by a board-certified foot surgeon and an individualized care plan should be created that is specific to the individual patient’s needs. Keep in mind, there is still time now to correct foot pain and enjoy the late summer!
Board certified foot and ankle surgeon Dr. Ujjwal Datta is affiliated with The Surgery Center at Old Bridge, located in the new, state-of-the-art Medical and Surgical Pavilion, 2 Hospital Plaza, Raritan Bay Medical Center. He is a member of the medical center’s Human Motion Institute, a comprehensive musculoskeletal program dedicated to returning patients to normal activities quickly and safely with help from a nurse navigator who guides patients and their families through surgical care. Dr. Datta is also certified in extra corporal shock wave therapy, an innovative, non-invasive treatment modality to treat patients suffering from chronic heel and arch pain. He specializes in extra osseous talo tarsal stabilization, a surgical procedure to correct over pronation, heel pain, and flat feet. For an appointment, call 855- 5-MOTION. For more information, visit www.gardenstatepodiatrist.com.