Bunion is a bump that forms on the outside of the big toe. This foot deformity occurs from years of pressure on the big toe joint (the metatarsophalangeal, or MTP, joint). Eventually, the toe joint gets out of alignment, and a bony bump forms. The medical term for bunions is hallux abducto valgus.
Types of Bunions
Bunions on the big toe are the most common. Other types include:
• Congenital hallux valgus: Some babies are born with bunions.
• Juvenile or adolescent hallux valgus: Tweens and teens between the ages of 10 and 15 may develop bunions.
• Tailor’s bunion: Also called a bunionette, this bunion forms on the outside base of the little (pinky) toe.
Symptoms for bunions
A bunion resembles a turnip — red and swollen. In fact, some sources say the word bunion comes from the Greek word for turnip. Other symptoms include:
• Inability to bend the big toe, or pain and burning when you try to bend it.
• Difficulty wearing regular shoes.
• Corns or calluses (thickened skin).
• Hammertoes (painful, tight toe tendons and joints).
• Numbness in the big toe.
• pain and stiffness of the big toe joint
• swelling of the big toe joint – the foot may become so wide it can be difficult to find wide enough shoes
• difficulty walking
• arthritis in the big toe
• Corns or calluses — these often develop where the first and second toes rub against each other
• Ongoing pain or pain that comes and goes
• Limited movement of your big toe
• Tight or badly fitting shoes: Wearing tight or badly fitting shoes puts extra pressure on the big toe joint and causes friction on the overlying skin. This tends to make the problem worse
Causes of bunion
Pressure from the way you walk (foot mechanics) or the shape of your foot (foot structure) causes your big toe to bend in toward the second toe. Bunions happen gradually over time. Standing for long periods and wearing ill-fitting, narrow shoes can make bunion pain worse, but they don’t cause the problem.
• genetic (hereditary) tendency to have a weakness of this joint
• a joint problem such as osteoarthritis or rheumatoid arthritis
• Inherited foot type
• Foot stress or injuries
• Deformities present at birth
Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to the development of bunions.
Your doctor can identify a bunion by examining your foot. After the physical exam, an X-ray of your foot can help your doctor determine the best way to treat it.
- Treatment options vary depending on the severity of your bunion and how much pain it causes.
Conservative treatment: Nonsurgical treatments that may relieve the pain and pressure of a bunion include:
- Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes.
- Padding. Over-the-counter, nonmedicated bunion pads or cushions may be helpful. They can act as a buffer between your foot and your shoe and ease your pain.
- Medications. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help you control the pain of a bunion. Cortisone injections also might help.
- Shoe inserts. Padded shoe inserts can help distribute pressure evenly when you move your feet, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter supports can provide relief for some people; others require prescription orthotic devices.
- Applying ice. Icing your bunion after you’ve been on your feet too long or if it becomes inflamed can help relieve soreness and swelling. If you have reduced feeling or circulation problems with your feet, check with your doctor first before applying ice.
- Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) both oral and topical can be combined with ice packs help with pain and swelling.
- Physical therapy: Massage, physical therapy and ultrasound therapy can break up soft-tissue adhesions to reduce pain and inflammation. There are actually exercises that can help improve muscle strength around the bunion and can modestly improve alignment.
- Medication: Many people take medication to cope with their pain and symptoms, and help them remain active.
You may be prescribed pain medication to ease the pain. Make sure you take any medication as prescribed, and get advice from a GP, pharmacist or suitably trained healthcare professional.
- Surgery: You may be referred for assessment by an orthopaedic or podiatric surgeon if other treatments don’t help and your bunion is very painful.
An operation won’t return your foot to normal but most people find it reduces their symptoms and improves the shape of their foot.
Surgical procedures for bunions can be done as single procedures or in combination. They might involve:
- Removing the swollen tissue from around your big toe joint
- Straightening your big toe by removing part of the bone.
- Realigning one or more bones in the forefoot to a more normal position to correct the abnormal angle in your big toe joint.
Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life.
• Keep track of the shape of your feet as they develop over time, especially if bunions run in your family.
• Exercising the feet can strengthen them. Learn to pick up small objects, like a pencil or pebble, with your toes.
• Wearing padded socks to reduce pressure on the foot.
• Padding and taping the bunion to reduce and alleviate pain
• Medications such as acetaminophen and anti-inflammatory drugs, and cortisone injections.
If conservative treatment doesn’t provide relief from symptoms, a number of surgical procedures are often performed for bunions. A bunionectomy typically involves removing the swollen tissue from around the big toe joint, straightening the big toe by removing part of the bone, realignment of the metatarsal bone to reduce angular deformity, or permanently joining the bones of the affected joint.
These factors might increase your risk of bunions:
• High heels. Wearing high heels forces your toes into the front of your shoes, often crowding your toes.
• Ill-fitting shoes. People who wear shoes that are too tight, too narrow or too pointed are more likely to develop bunions.
• Rheumatoid arthritis. Having this inflammatory condition can make you more likely to develop bunions.
• Heredity. The tendency to develop bunions might be the result of an inherited problem with the structure or anatomy of your foot.
• Family history of bunions due to inherited foot structure problems, like flatfeet.
• Foot injuries.
• Inflammatory diseases, such as rheumatoid arthritis.
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