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Sprained toe.

by Trinh
(San Antonio, TX)

I recently went to the doctor's because I had hurt my foot really badly in martial arts class. The doctor told me I sprained big toe on my left foot. However, there's a huge bump on the side of my foot, and it makes my big toe angle in towards my other toes. It isn't a big angle, but it's noticeable. I am just wondering if this is a bunion, or something else. And if it will go away. Please any feedback is appreciated, because I'm freaking out about this. I don't want my foot to look deformed and work differently.


RESPONSE
Hi Trinh,

Yes, it sound like a bunion to me. Bunions are usually cause by your foot structure and your gait. These traits tend to be inherited, so you might find that some of your immediate relative also have bunion deformities.
Bunions can be present without being painful, but in general bunion deformities are progressive in nature so as time goes on the deformity will worsen in most individuals.
So, the question becomes what are you going to do about this?
When people are excessively flat-footed, many times we put people in orthotics to control the excessive pronation (foot flattening out) which is usually the underlying source in the formation of bunions.
If your foot structure is of that nature than an orthotic might help you in the sense that it would slow down the progress of the bunion formation, it will not however, straighten your toe back to its original position.
Unfortunately the only way the toe can be straightened is through surgical correction. The dilemma here is do you have surgery on a bunion that does not hurt? I cannot tell you what to do but my philosophy is that you do not have surgery for cosmetic reasons (as would be the case here) because quite frankly there are no guarantees in surgery, so there is always the chance your foot would be worse after surgery.
Now, it the bunion were to become painful, surgery would be a consideration, because the risks of surgery would out-weighed by the potential reward in resolution of your pain.
You state that you have a "huge bump" on the side of your foot and when we foot specialists evaluate bunions the type of deformity will determine the type of procedure to be performed. This can be as simple are removing the bump, all the way to surgically breaking the first metatarsal bone and resetting it to change its ankle.
My best advice would be to see a foot specialist in your area and have the bunion evaluated to give you a better idea of just how bad it really is. As I stated earlier, if there is no pain associated with the bunion I would not be inclined to have surgery, at this point in time.

Marc Mitnick DPM
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