Your feet have 26 bones, 33 joints and 100 tendons. You also have 3 bones in your ankle, plus several ligaments and tendons.

Not only that, but your feet also bear your weight every day. Your toes sit inside your shoes and work to connect you with the ground. And your ankles have to respond quickly to twists and missteps.

It’s a delicate system where many things can cause pain and trouble walking.

Most foot and ankle problems we see are due to:

• Wearing shoes that don’t fit properly or put your foot in an unnatural position
• Chronic overuse that happens with activities like running, dancing or playing court sports on a hard surface
• Falls and ankle twists related to ​sports or everyday life
• “Wear and tear” osteoarthritis or ​rheumatoid arthritis

The foot and ankle conditions we see most often include:

• Bunions: These are bony bumps that form at the base of your big toe and can be painful.
• Sprains: Injuries to the ligaments, or sprains, are most common in the ankle, but you can also sprain toes.
• Tendon injuries: Strains are mild injuries to the muscles or tendons. Tendonitis is when tendons become inflamed. You can also tear tendons, which is much more serious.
• Fractures: A fracture is a broken bone. You can break any bone in your foot or ankle, including your heel bone.
• Nerve disorders: These can cause tingling, numbness or sharp pain in your feet. Conditions like ​​diabetes can cause nerve problems, as can a pinched nerve in your back.
• Foot and ankle trauma: This includes serious fractures and severe accidents, including severed toes or crushed bones.
• Toe injuries: This includes conditions like ingrown toenails, corns, dislocations and toe sprains. Toes can also bend unnaturally at the middle joint, called hammertoe.

What are bunions?

A bunion is a bump that forms on the side of your big toe. It makes your toe joint stick out.

This bump occurs when some of the bones in the front part of your foot move out of alignment. The big toe leans toward the smaller toes, forcing the joint at the base of your big toe to stick out rather than point straight ahead.

When a bunion gets big enough, your big toe can start pushing toward your smaller toes. Bunions can be painful. Walking can be uncomfortable when bunions grow too large and make it difficult to wear shoes.

Bunions are more common in women than men. There is a genetic component (about 70% of people with bunions have a family history of them). Wearing high-heeled shoes with a narrow toe box is one of the biggest risk factors for developing bunions.

Some foot and ankle injuries are emergencies. If the injury is severe, you may need surgery immediately.

Not every foot or ankle problem is surgical. Often, surgery is not the first line of treatment. If we can, we start with treatments like:

• Lifestyle changes: We can talk to you about habits or activities that might worsen your foot or ankle pain. For example, wearing different shoes can help with bunions.
• Medicine: We may have you take over-the-counter anti-inflammatory medicine. In some cases, we’ll prescribe stronger anti-inflammatories.
• Pain injections: For some conditions, steroid shots directly into your ankle joint can relieve pain for up to 3 months.
• ​​Physical therapy: Your doctor may refer you to work with a physical therapist, who will design a specific program to treat your foot or ankle condition.
• Splinting: Wearing a splint or brace can help immobilize your foot or ankle, so it heals more quickly.

For people who need surgery, our foot and ankle surgeons offer the latest, minimally invasive surgeries. We’re experts at ankle replacements. Learn more about ​how Carilion treats foot and ankle injuries.

Bunions can become painful over time, especially if they grow larger. Bunions can even lead to hammertoe, which pushes your toes out of alignment.

However, there are many ways to treat bunions without surgery. If you think you have a bunion, visit your doctor sooner rather than later. The more quickly you make changes, the better your chance of keeping the bunion from growing.

The most common things we suggest are:

• Changing your footwear: Switch to shoes with a wider toe box.
• Wear protective shoe padding: These pads (which you can buy at most pharmacies) help cushion your bunion.
• Orthotics: You can buy over-the-counter shoe inserts that help take pressure off your foot. We can also prescribe a custom orthotic.

Some people may need bunion surgery. It can help ease pain and correct the problem by realigning the bones that make up the big toe.

Carilion’s orthopaedic surgeons provide expert care to alleviate pain from bunions and other foot deformities. We offer 2 types of minimally invasive bunion surgery.

MICA bunion procedure

Minimally Invasive Chevron and Akin (MICA) bunion surgery is a minimally invasive surgery that uses tiny incisions used to cut and realign the bones.

This technique allows for minimal disruption to soft tissue. It results in less pain and swelling after surgery. You can return to normal activity quickly. 

Once we realign the bone, we use specially designed screws to hold it in position. These screws sit flush, and you don’t feel them. Since there is less disruption to the soft tissue, patients can walk immediately.

Lapiplasty 3D correction

Lapiplasty is a type of surgery that fixes the root cause of bunions—an unstable joint.

We use advanced fixation technology to restore your big toe joint to its normal anatomy. It addresses all 3 dimensions of the joint. We reposition the metatarsal bone vertically, horizontally and rotationally.

We restore the affected bones to their proper alignment. This corrects the alignment of the unstable joint. To secure the joint, we fuse it with titanium plates.