Another less frequent type of bunion is Juvenile Bunion or Juvenile Hallux Valgus In this condition there is a severely deformed first metatarsal joint. The lateral deviation of the big toe usually develops in childhood or early teenagers. Its etiology is the poor development of the distal joint surface of the big toe. The joint is intact, the base of the joint is protruding medially, and no osteophyte or bony spur is seen in this case. Severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. Hallux valgus is the commonest forefoot deformity, with an estimated prevalence of 23% to 35%. It causes symptoms on the medial edge of the foot, the sole, and the small toes. Non-operative treatment may alleviate symptoms but does not correct the deformity of the big toe. Surgery is indicated if the pain persists. The correct operation must be selected from a wide variety of available techniques. A radiograph with the patient in standing position shows the angle between metatarsal I and metatarsal II, as well as the congruence of the first metatarsophalangeal joint and any signs of osteoarthritis. Bunions are a progressive deformity. This means that over time the bump will continue to grow, unless you quit walking. The great toe will continue drifting towards and under the pointer toe until the pointer toe is cocked upwards. The good news is that a bunion may take up to sixty some years in the making. Avoiding tight shoes and wearing orthotics may slow the progression of this deformity and foot pain. Anyone can get bunions, but they are more common in women. People with flat feet are also more likely to get bunions due to the changes in the foot caused by bunions. Adequate physical examination to determine the etiology and specific deformity is necessary for treatment planning. Medical therapy can be used to address its cause, but it cannot change the irreversible cartilage, bony, and soft-tissue adaptations of the deformity. Consequently, most medical therapies are aimed at relieving the symptoms. Surgery to correct the underlying bone deformity may be indicated for bunions that do not respond to conservative treatment. Surgery is recommended if a bunion causes severe pain or if there is neuritis/nerve entrapment, the great toe overlaps/underlaps the second toe, or ulceration is present. Contraindications to surgery include active infection and extensive peripheral vascular disease. My next step was to recreate a new resting place in the house for ME! And as you can see Allie thought I was creating her a new soft spot to rest! Again the story of my life with this dog of mine. Like almost everyone in the western world, I grew up wearing socks with shoes. No questions asked, socks it was. No matter if they were dress shoes, sneakers, running shoes, cycling shoes, or boots, everything but sandals deserved socks.