A bunion is an enlargement at the base of the big toe caused by a misalignment of the joint. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position. of the big toe and a bunion refers to the enlargement of the joint, most of the time the two go together and can just be referred to as ?bunions?. Bunions are really only a symptom of faulty foot mechanics and are usually caused by the foot we inherit and inappropriate footwear use. As the big toe bends towards the others this lump becomes larger and the bunion can become painful - arthritis and stiffness can eventually develop.
The commonest cause of bunions is prolonged wearing of poorly designed shoes such as the narrow high heels that women wear. This is one of the reasons why bunions are much more common in women than in men. There is also a hereditary component to bunions in that many times we will see a grandmother, mother and daughter all with various stages of bunions. 38% of women in the United States wear shoes that are too small and 55% of women have some degree of bunion formation. Bunions are 9 times more common in women than they are in men.
SymptomsRedness, swelling, or pain along the inside margin of the foot just behind the great toe. Moderate to severe discomfort at the bunion when wearing shoes, particularly if tight fitting. A painful callus may develop over the bunion. Sometimes a painful corn on the adjacent sides of the first and second toes. Irritation if there is overlapping of the first and second toes. Arthritis may cause stiffness and discomfort in the joint between the great toe and the first metatarsal. There may be a fluid filled cyst or bursa between the skin and the "bunion bone". Skin over the bunion may break down causing an ulceration, which can become infected.
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.
Non Surgical Treatment
Initial treatment of bunions may include wearing comfortable, well-fitting footwear (particularly shoes that conform to the shape of the foot and do not cause pressure areas) or the use of splints and orthotics (special shoe inserts shaped to your feet) to reposition the big toe. For bunions caused by arthritis, medications may help reduce pain and swelling. If nonsurgical treatment fails, your doctor may suggest surgery, which resolves the problem in nearly all persons. The goal of surgery is to relieve pain and correct as much deformity as possible. The surgery is not cosmetic and is not meant to improve the appearance of the foot. Other related procedures that may be used to help diagnose foot disorders include X-rays of the bone and foot.
Bunions can cause pain and difficulty wearing certain shoes. When simple treatments don't relieve your symptoms, surgery may be considered for treatment of the bunion. What are the signs that surgery may be the right treatment for your bunion? In general, surgery is recommended only when pain from the bunion prevents a patient from wearing normal shoes. There is a common misconception that surgical treatments for a bunion are better and quicker than non-surgical treatments. Unfortunately, patients who rush into surgery may have unrealistic expectations, and may be unsatisfied with surgery.
Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. Medicine will not prevent or cure bunions.