Discussing Treatments for Bunions with Dr. Steven A. Kulik Jr.

Steven A. Kulik Jr., MD, a surgeon with GBMC Health Partners Orthopaedics, discusses treatment options for painful and uncomfortable bunions with Ashley James from WMAR-TV - abc2news.com.

Bunions are bony bumps that protrude from the base of the big toe. This creates a misalignment in the foot that pushes the big toe towards the adjacent toe. Bunions often run in families, but they are most commonly caused by inappropriate footwear. Consistently wearing shoes that are too narrow or have a heel will put you at a greater risk for getting a bunion. Because of shoe styles, women are nine times more likely than men to develop bunions.

The major symptoms of bunions include:

• Swelling of the foot
• Pain and tenderness around the big toe
• Turning of big toe towards the adjacent toe
• Change in the shape of the foot
• Pain and discomfort while walking
• Restricted movement of the big toe

The easiest treatment for bunions is simply to wear wider shoes. For many patients, this can be enough to alleviate pain and stop the bunion from becoming worse. Ice and anti-inflammatories can also be used to relieve acute pain. If these steps don't work, surgical treatment may be necessary. Most bunion surgeries involve cutting the bone and realigning the foot, so it can take up to 12 weeks to fully recover. It used to be common practice to simply shave down the part of the bone that was protruding from the foot, but it was found that there was a 60% chance of recurrence with this procedure alone. When the actual alignment problem is addressed, there is only a 5% chance of recurrence.

Although bunion surgery can be fairly complex — there are more than 10 different operations that can be tailored to each patient — it is almost always an outpatient procedure. A local nerve block is administered to the knee and patients can walk the day of or the day after their surgery. However, just because someone has a bunion, doesn't mean they need surgery. "If someone comes in with a bunion and it doesn't hurt, we don't operate on it. The primary indicator is pain," said Dr. Kulik. If you are concerned about having a bunion, it's always best to talk to your doctor. "It's hard to navigate the medical field on your own, so you really need someone to help you with that. That's what doctors do."