Is That A Bunion On TOP Of My Foot???
Dr. Andrew Schneider
When we think of a bunion, we usually think of a large bump forming on the side of the great toe joint. Bunions can also occur on the top of the same joint, however, but for different reasons.
When a bunion occurs on the side of the foot, it is due to biomechanical forces that cause shifting and rotation of the first metatarsal bone. These forces are usually inherited. A bunion on top of the foot is known as a "dorsal bunion." A dorsal bunion is due to excessive mechanical force causing damage to the joint, such as a sprain or hyperextension injury such as turf toe. It is also very common in ballet dancers.
When this joint is injured, it leads to a bone spur forming on the top of the head of the first metatarsal. This spur limits the smooth gliding of the joint, with an abrupt blockage of motion. Repetitive motion causes stress and inflammation to occur, which continues the growth of the spur.
Pain from a dorsal bunion can come in different forms. As the spur enlarges, a solid bump forms on top of the joint. This can become painful due to pressure from shoes. Pain can also be due to activities that require more motion than is available in the joint. Tennis, golf, basketball, and running, especially on hills, are some such activities. A deal breaker for many women is when they are forced to limit their heel height, when the spur limits too much motion.
Treatment for a dorsal bunion varies and is based on when treatment is sought. Early treatment involves prescribing a custom orthotic to biomechanically stabilize the foot. This increases the available motion around the joint and helps to limit the forces that continue to damage the joint. In cases that are already more progressed, surgery to remove the spur and remodel and decompress the joint may be necessary.
Of course, as with any injury, treating it sooner will lead to much quicker control of the problem. Time only allows for continued injury to the joint. If you are in pain, be sure to give us a call today!
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