The Bunion Blues

You might be wondering how that big bump, otherwise known as a bunion, on the side of your first toe managed to get there. Bunions reflect a change in the boney structure of the foot over time. In other words, bunions tend to be progressive. As the big toe starts to turn in towards the second toe, a bump is formed with the changing angle of the foot. While bunions can be easily seen, some people might also experience pain with them over time.

But what actually causes a bunion? It’s all in the structure of the foot. Bunions tend to be inherited. So while you aren’t passing that bump from mother to daughter you are in fact passing the certain mechanics of your feet that might make you prone to developing a bunion. The most common symptom experienced with bunions is pain, because you will generally recognize this if you are wearing shoes that are rubbing against this site. Additionally, there might be redness, inflammation, or numbness as well.

If you might be thinking that it’s time to visit your local podiatrist to have this issue assessed, you might also be thinking – well I’ve basically already diagnosed it myself! I can see the bump right there! I know how to read WebMD! Your podiatrist, though, will be able to take some x-rays of your feet to be able to figure out the extent of the bunion deformity and where to take treatment from there. Which brings us to treatment. What can you do to treat these pesky bunions? There are two stages of treatment: mainly, conservative (or non-surgical) and surgical. Non-surgical works to help with the pain, but won’t correct the deformity. Some methods include changing shoe gear, medications, icing, padding, and orthotics. Surgical intervention should be considered when conservative methods have failed and no longer seem to be an option. With many treatment options available, your bunions won’t leave you singing the blues for long!

The Art of the Clinical Exam

How many times have you walked into your physician’s office only to hear that you must follow up with a series of additional tests to figure out what may be going on with you? The same may ring true in the field of podiatry. And while most times this might be warranted – for instance, an MRI to see if in fact you did tear that ligament in your foot – some physicians may utilize these diagnostic tools immediately even before performing a thorough clinical exam. As taught in podiatry school, we learn that aside from the history (the information patients provide), the clinical exam is still the most important tool for assessment of our patients.

Technology has done many great things for us today. We have the ability to see things that our eyes cannot physically see through the art of MRI and CT (computed tomography – used mainly to image complex fractures in our field). Due to this heightened awareness of what technology can do for us, patients and physicians alike may be more likely to rely on it.

There is no question that when these imaging studies are needed that it is important to utilize them. However, it is also key to remember that the origin of discovering a medical problem lies quite figuratively at the hands of the physician, and there is no substitute for that. So if you’re wondering why your physician is or isn’t ordering this or that additional test or is or isn’t sending you for an MRI to figure out why you have ankle pain, much of it lies in the systematic approach to figuring out the root of the problem.