A bunion, also known as hallux valgus (hallux means big toe, valgus means abnormally angled or deformed), is a painful condition of the large toe that can make it difficult to walk, stand and exercise.
A bunion can be described as an abnormal bump on the outside of the large toe that can become red, irritated and painful. Medically speaking, it is an overgrowth of bone at the first metatarsophalangeal joint.
Bunions and Osteoarthritis
Overgrowth of bone in any joint, including the great toe, is usually related to joint instability caused by ligament laxity or “looseness.” This overgrowth of bone is part of the osteoarthritic process that can cause pain and stiffness in any joint. As a result of a traumatic injury or repetitive motion, the ligaments that stabilize the large toe and all other joints can become injured. If the body cannot heal the ligament injury, the body “fixes” the problem by overgrowing bone. Yes, the instability is cured alright, but the person is left with a painful and overly stiff or stable joint. Dramatic depictions of this bone overgrowth can be seen on x-ray or MRI imaging as bone spurs, common in the shoulder, heel and vertebrae. Ligaments are made to stretch to allow for normal motion but bone is not. If ligament laxity is not addressed, the cartilage in the toe becomes prematurely worn causing more pain and disability.
Causes of Bunions
Bunions can occur after years of jamming feet into shoes that are too tight, especially in the toe box of the shoe. Women who wear high heels face a double-whammy of having a narrow toe box and placing the large toe in a downward position with the weight of the body pressing forward with each step. We always say, high heels are fine, as long as you don’t walk in them. Some runners, especially those with a forefoot first strike, are prone to bunions if they do not have well-fitted shoes. Evidence shows that some people may be genetically prone to bunions. American’s foot health in general lags behind inhabitants of some less-developed countries. We tend to wear very protective and supportive shoes, which tends to make the structures of our feet weaker over time. Contrast this to a Kenyan or Mexican Indian youngster who has an interest in sports/running. They certainly do not have access to the latest $130.00 Nikes. They grow up walking and running barefoot or with very flimsy shoes, and studies have shown they have few foot problems in comparison to people in more-developed countries. This phenomenon has spurred the surge in the development of shoes that mimic “barefoot running”, which offer little support compared to the more traditional running shoes.
Prolotherapy for Bunions
Traditional treatments for bunions include pain and anti-inflammatory drugs, and orthotics. When these measures invariably fail, surgery is imminent. Whatever the cause of bunions, a good Prolotherapy doctor like Dr. Hauser can strengthen and tighten damaged and lax ligaments, resulting in less pain and dysfunction of your big toe. Prolotherapy is an injection treatment that causes a mild inflammatory response that initiates an immune response. This mimics what the body does naturally in response to soft tissue injuries. A good Prolotherapy doctor, besides being skilled in the injection technique, should be able to counsel his patients on how to prevent recurrence of the ligament injury and resulting pain. As a board-certified physiatrist (Physical Medicine and Rehabilitation), Dr. Hauser is trained to help people rehab from a wide variety of joint problems due to injury, stroke and disease processes. He would counsel a bunion patient to do a variety of exercises along with Prolotherapy to get more motion in the affected toe. Contrary to the accepted wisdom of limiting exercise and stress on painful and arthritic joints, a recent article in the Wall Street Journal stated, “Studies have shown that weight loss, combined with exercise aimed at improving joint function and building up muscles that support the joints, can significantly improve patients’ health and quality of life…” This philosophy coincides with ours at Caring Medical. One way of defining pain is pain is weakness. Prolotherapy in general is a way to heal and strengthen damaged structures, like damaged metatarsophalangeal joints afflicted with bunions.
So if you or someone you know is suffering from the pain of bunions and they are affecting your ability to enjoy life as you once did, call us at Caring Medical to set up an appointment with Dr. Hauser. He will perform a detailed exam and help you devise a plan to resolve your bunion pain.