Bunion: Elena’s Struggle for Comfort

Written by: Marcos Otero, Retired Physician Associate

Our Patient:

Patient: Elena, a 48-year-old office worker

Location: Buenos Aires, Argentina

Diagnosis: Bunion

Background:

Elena has a family history of bunions and often wears narrow, fashionable shoes for work. She spends long hours seated but walks several blocks daily to and from public transportation.

Presentation of Symptoms:

Elena began noticing swelling and discomfort in her big toe joint years ago, but the pain and misalignment have worsened over time, making daily activities challenging.

Key Symptoms:

Her symptoms impact both her work and social life.

• A visible bony bump at the base of her big toe.
• Pain and redness around the joint, especially after walking.
• Difficulty finding shoes that fit comfortably.

Diagnosis & Treatment:

• Diagnosis: A bunion confirmed through physical examination and X-rays showing joint misalignment.
• Treatment Plan:
  • Switching to wide, supportive shoes.
  • Applying ice packs to reduce swelling.
  • Using custom orthotics and toe separators.
  • Surgery recommended if symptoms persist.

Treatment Plan:

• Switching to wide, supportive shoes.
• Applying ice packs to reduce swelling.
• Using custom orthotics and toe separators.
• Surgery recommended if symptoms persist.

Complications:

Without intervention, Elena risks worsening joint damage, arthritis, and chronic pain, potentially requiring more invasive surgical procedures.

Cultural and Family Support:

Elena’s family, especially her mother, shares advice based on personal experience but hesitates to support the idea of surgery due to cultural fears surrounding recovery.

Life Today: Possible Outcomes

• Good Outcome: Elena opts for surgery, follows a thorough recovery plan, and can walk pain-free while enjoying a more active lifestyle.
• Bad Outcome: Reluctance to seek treatment leads to worsening pain and deformity, making surgery inevitable but with a longer, more complicated recovery.