Anyone that has been to the doctor for their bunion pain knows that genetics and a physical exam are the two area of focus for the man in the white coat.
First genetics; bunions aren’t exactly genetic but just like everything else in your DNA, your bone structure is (including those that make up your feet).
Second; a physical examination will really be the litmus test. The doctor will measure your big toe angles, look for redness, sensitivity, and inquire about the pain level and times when the pain is exacerbated (based on type of shoe and activity).
Below is a representation of the life-cycle of bunion treatments. There is always the suggestion that the patient take it upon themselves to make responsible and reasonable choices when it comes to footwear, but beyond home remedies such as ice and over the counter pain management aids, you are looking at orthotics, extreme shoe modifications, and prescription pain medicines. If that doesn’t work, patients usually resort to surgery and while the chance of correcting the bunion is good, often times the complications and resulting pain in other areas of the foot, make it a less than desirable treatment option.
For reference;
The HA Angle is the Hallus Abductus Angel measures the angle between the first metatarsal and the big toe.
The IM Angel is the Intermetatarsal Angle and measures the area between the first and second matatarsals (the bones that make up the ball of the foot, behind the toes). Surgery attempts to realign this angle.
You can also visit this site for a visual representation of the levels of deformity.
Source: Clinical Practice Guidelines First Metatarsaphalangeal Joint Disorders Panel. Copyright reserved by the Academy of Ambulatory Foot and Ankle Surgery.
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