A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe ( metatarsophalangeal joint ). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallux Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.
Bunions most commonly affect women. Some studies report that bunion symptoms occur nearly 10 times more frequently in women. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Tight footwear certainly is a factor in precipitating the pain and swelling of bunions. Complaints of bunions are reported to be more prevalent in people who wear shoes than in barefoot people. Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital) and arthritic diseases such as rheumatoid arthritis. In some cases, repetitive stresses to the foot can lead to bunion formation. Bunions are common in ballet dancers.
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Bunions are progressive problems, meaning they tend to get worse over time. Sometimes severe-looking bunions don't hurt much, and sometimes relatively modest-looking bunions hurt a great deal. Thus, treatment varies depending upon a patient's symptoms. You can often improve the discomfort of bump pain by a change to more proper shoes. Alternatively, alterations to existing shoes may improve pain associated with bunions. Accommodative padding, shields and various over-the-counter and custom-made orthopaedic appliances can also alleviate bunion pain. Anti-inflammatory medications, steroid injections, physiotherapy, massage, stretching, acupuncture and other conservative treatment options may be recommended by your podiatric physician to calm down an acutely painful bunion. Long term, orthoses (orthotics) can address many of the mechanical causes of a bunion. Thus, while orthoses don't actually correct a bunion deformity, if properly designed and made, they can slow the progression of bunions. They can also be made to redistribute weight away from pain in the ball of the foot, which often accompanies bunion development. Padding, latex moulds and other accommodative devices may also be effective. While they don't correct the misalignment in the bones, they may alleviate pain. Often, though, when conservative measures fail to alleviate pain associated with the bunion, when you start to limit the types of activities you perform, when it's difficult to find comfortable shoes, and when arthritis changes how you walk, surgery may be the best alternative.
Surgery isn't recommended unless a bunion causes you frequent pain. A bunionectomy, like other types of surgery, is not without risk. Additionally, you may still have pain or you could develop a new bunion in your big toe joint after surgery. Consider trying conservative treatment before having a bunionectomy.If you have an underlying mechanical fault,surgery will only correct the aesthetical nature of your bunion for a short period.So therefore surgery is not recommended.
If the diagnosis is made early on, such as in preadolescence, bunion development can be slowed and in some cases arrested with the proper supportive shoe gear and custom functional shoe inserts (orthotics). Avoidance of certain athletic activities with improper shoe fit and toe pressure can prevent the symptoms that occur with bunions.