When is a Bunion Not a Buinon?

It happened again today in my office. A womanand then a bump that forms usually more toward the
came in asking for bunion surgery. She had put uptop of the joint, not the side like Hallux valgus.
with the pain in her big toe for years and finally hadHallux valgus and Hallux limitis can occur together in a
had enough. Many years ago her family physician toldmore complex foot deformity. Usually the bunion
her to wait until she couldn't stand the pain in herdeformity has progressed and then is injured by
foot before discussing surgery with a podiatrist. Likerepetitive trauma or a distinctive injury. This starts
many physicians, they assumed any pain in the greatthe progression of the arthritis change. Bottom line:
toe accompanied by a bump was a "bunion" or Halluxdon't ignore pain in your great toe joint. Treatment
Abducto Valgus. Unfortunately in this case, herof Hallux limitis early can save you from needed a
doctor was wrong. The patient actually has Halluxfusion or joint replacement!
Limitis also known as osteoarthritis of the great toeWhy is treatment of Hallux limitis so important in the
joint. If she had sought treatment many years ago,early stages? Once you have destroyed the cartilage
her joint may have been salvaged. Now her joint wasin your joint, there is nothing a physician or surgeon
so destroyed that she needed a joint replacement orcan do to make more cartilage. Research is
fusion. Not what she wanted to hear! In her mind,underway trying to replace or regrow cartilage, but
she came in the office asking for a simplewe are many years from a solution. Hallux limitis in
bunionectomy and left needing a joint replacement.the early stages can be controlled with a functional
She regretted not seeking the advice of a podiatristshoe orthotic to control the biomechanics. A clean up
earlier.procedure known as a cheilectomy can help remove
So what's the difference between Hallux valgus andall the debris from the joint and get rid of much of
Hallux limitis?the crunching. This will slow down the progression.
Hallux valgus is a crooked big toe joint. Over a periodSome patients can really benefit from a surgical
of years, the great toe becomes much friendlier withprocedure to realign and shorten the metatarsal to
the second toe and drifts toward and eventuallygive the joint better biomechanics and more joint
under or over the second toe. At the same time, thespace. Unaddressed Hallux limitis leads to complete
first metatarsal (long bone connected to the greatjoint destruction and the need for a fusion or joint
toe) drifts towards the center of your body makingreplacement.
the distinctive bump. This starts out as a minorThe flip side to this story is that patients with Hallux
annoyance, but then quickly becomes a shoe problemvalgus or your tradition bunion can often delay
with rubbing on the bump. Most people seek thetreatment until they start to have pain. Bunions in the
attention of a podiatrist when the bump is rubbing inearly stages are a cosmetic concern, but the joint is
their shoe and becomes painful. If the deformity isusually not damaged until the later stages. It is
allowed to progress, the great toe joint can actuallyimportant to address Hallux valgus when it starts to
start to dislocate and you will start to experiencehurt so the joint is not permanently injured, but a
joint pain and degeneration.bump, in the absence, of pain can wait.
Hallux limitis is wear and tear arthritis or osteoarthritisThe take home message is to have your great toe
of the great toe joint. Many people are predisposedpain examined by a podiatrist. A full examination
to have this problem by the underlying biomechanicalincluding functional biomechanics and x-rays can
function of their joint. It becomes much worse afterdetermine whether your pain is from Hallux valgus,
an injury or repetitive trauma from things like highHallux limitis or a combination. Only then can you
heeled shoes, ballet or some sports. The symptomsmake an informed decision on treatments for your
are different than Hallux valgus. Hallux limitis usuallyfoot deformity and pain. Waiting until you can't stand
starts with a feeling of stiffness of the joint. It canit anymore is a recipe for unhappy outcomes! If you
be accompanied by swelling and redness. This usuallyhave great toe pain with or without a bump, don't
progresses to a decrease in range of motion, adelay. See your podiatrist today!
distinctive crunching feeling when moving the joint