Bunions and Botox

Bunions are frequently seen abnormality of the first metatarsophalangeal joint. There is no way to get rid of the actual deformity from a non surgical standpoint. Yes you can find wider shoes or take medicine for pain.Thus making surgery the only definitive treatment option for the actual deformity. The problem arises if the patient is not a surgical candidate for whatever reason, what is one to do.  Recently published  is a technique in which the use of botulinum toxin A injection reduced not only the hallux abducto valgus deformity clinically and radiographically but also its associated pain.(J Am Podiatr Med Assoc 98(1): 61-65, 2008) I have had similar good results as well.

How does it work you ask . In hallux abducto valgus (bunion) deformity the abductor hallucis muscle demonstrates decreased activity compared with the adductor muscle.7 This discrepancy allows the adductor hallucis muscle to gain mechanical advantage and to pull the hallux laterally while forcing the metatarsal medially. It has been shown that injecting botulinum toxin A into adductor hallucis muscle motor end plates in a predetermined quantity could temporarily paralyze the muscle by eliminating one of the deforming forces of the bunion deformity. I believe that the injection indirectly strengthens the abductor hallucis muscle and allows it to regain some advantage and to reverse or prevent, at least temporarily, progression of the deformity.

I believe that botulinum toxin A therapy will play a beneficial role when used as a prophylactic treatment option during the initial stage of bunion deformity and can slow its progression. The pain associated with the deformity can be managed with this therapy and has long-term benefits.