A bunion is a bony deformity of the joint at the base of the big toe. The medical name is hallux valgus. The main sign of a bunion is the big toe pointing towards the other toes on the same foot, which may force the foot bone attached to it (the first metatarsal) to stick outwards. Other symptoms may include a swollen, bony bump on the outside edge of your foot, pain and swelling over your big toe joint that's made worse by pressure from wearing shoes hard, callused and red skin caused by your big toe and second toe overlapping, sore skin over the top of the bunion, changes to the shape of your foot, making it difficult to find shoes that fit. These symptoms can sometimes get worse if the bunion is left untreated, so it's best to see a GP. They'll ask you about your symptoms and examine your foot. In some cases, an X-ray may be recommended to assess the severity of your bunion. Anyone can develop a bunion, but they're more common in women than men. This may be because of the style of footwear that women wear.
Bunions form when the normal balance of forces exerted on the joints and tendons of your feet are disrupted. This can lead to instability in the big toe joint - also known as the first metatarsophalangeal (MTP) joint, causing a deformity. Bunions develop over years of abnormal motion and pressure on your big toe joint. They often result from a combination of your inherited foot type, faulty foot mechanics that affect the way you walk and shoes that fit improperly. Other causes of bunions include foot injuries. Deformities present at birth (congenital). Neuromuscular disorders, such as cerebral palsy or post- polio syndrome (post-poliomyelitis). Bunions may be associated with various forms of arthritis, including inflammatory or degenerative, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet also can be a cause. Waiters, factory workers, dancers and athletes often are more prone to developing bunions.
Bunions may or may not cause symptoms. A frequent symptom is foot pain in the involved area when walking or wearing shoes; rest relieves this pain. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. Shoe pressure in this area can cause interment pain while the development of arthritis in more severe bunions can lead to chronic pain. Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness. It is important to note that, in postpubertal men and postmenopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that is similar to the pain caused by bunions.
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by Arthritis, which causes destruction of the cartilage of the joint. Gout, which causes the accumulation of uric acid crystals in the joint. Tiny fractures of a bone in the foot or stress fractures. Infection. Your doctor may order additional tests to rule out these possibilities.
Non Surgical Treatment
Custom orthoses or over-the-counter insoles to aid big toe joint function, help control over-pronation and maintain proper alignment of the bones in the feet. Properly sized, supportive footwear that are torsionally stable (can?t be folded or twisted easily) and that feature a good ?rocker profile? (curved from the ball to tips of the toes) help to reduce stress on the joint when walking. Footwear modifications to expand the area of the shoe surrounding the bunion to relieve pressure. Physical therapy modalities include rest, icing and massage. Injections, surgery and other treatment options, please consult your medical doctor for information and/or referral to a podiatrist or other foot and ankle specialist.
Larger bunions are commonly treated with the Lapidus Bunionectomy, which involves realigned the displaced bone at its bottom, through a bone mending/fusion procedure. It is with this technique where the the walking advances have been made int he past decade. The Lapidus Bunionectomy has become a popular surgical method since surgeons have become more comfortable with mobilizing their patients post-operatively. Though not all surgeons who perform this procedure have adopted this postoperative protocol.