Overview
A bunion is enlargement of bone or tissue that develops at the joint that connects your big toe to your foot. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and running. When the joint, called the metatarsophalangeal joint, or MTP joint, experiences abnormal, prolonged stress in terms of weight distribution or squeezing of the toes within the shoe, the result can be the deformity called a bunion. Generally, a bunion develops when, as a response to prolonged stress, your big toe begins bending toward your foot's smaller toes and puts pressure on your MTP joint, forcing it to bulge outward (the term "bunion" comes from the Latin word for "enlargement"). There is no "standard" bunion, however, but rather a complex range of joint, bone and tendon abnormalities that can cause variation in each bunion's make-up.
Causes
Abnormality in foot function, particularly a pronated foot. This is probably the most important and common causative factor. Family history of bunions. Narrow toed dress shoes and high heels may contribute to the formation of a bunion. Rheumatoid and Psoriatic arthritis. Genetic and neuromuscular disease (eg. Down's,Ehler-Danlos and Marfan's syndromes) resulting in muscle imbalance. Limb length inequality can cause a bunion on the longer limb. Generalized laxity of the ligaments. Trauma to or surgery on the soft tissue structures around the great toe (first metatarsal-phalangeal) joint.
Symptoms
If a foot bunion is developing, you may experience some of these symptoms. Bulge or bump on the outside of the base of your big toe. Swelling. Redness. Soreness. Thickening of the skin in that location. Corns or calluses. Limited movement of your big toe. Persistent or periodic pain. The pain you experience may be mild or severe. It may become increasingly difficult to walk in your normal shoes. The pressure on your other toes can cause your toenails to grow inward or your smaller toes to become bent.
Diagnosis
Although bunions are usually obvious from the pain and unusual shape of the toe, further investigation is often advisable. Your doctor will usually send you for X-rays to determine the extent of the deformity. Blood tests may be advised to see if some type of arthritis could be causing the pain. Based on this evaluation, your doctor can determine whether you need orthopaedic shoes, medication, surgery or other treatment.
Non Surgical Treatment
The initial treatment of a bunion should be non-operative. Symptoms can often be greatly improved with simple non-operative interventions. Non-operative treatment may include properly fitted shoes, Properly fitting comfort shoes with a wide non-constrictive toe box, especially one that is made out of a soft material such as leather, can be quite helpful in reducing the irritation over the prominent bunion. In some instances, it is helpful to have a shoemaker stretch the inside aspect of the shoe. Jamming a foot with a bunion into a constrictive shoe will likely lead to the development of uncomfortable symptoms. Bunion pads, Medial bunion pads may also be helpful in decreasing the symptoms associated with the bunion. These pads can be obtained at many drugstores. Essentially, they serve to lessen the irritation over the medial prominence and, thereby, decrease the associated inflammation This should be combined with comfortable non-constrictive shoes. A toe spacer placed between the great toe and the second toe can help to reduce the bunion deformity and, thereby, decrease the stretch on the medial tissue and the irritation associated with the bunion. Toe spacers can be obtained at most drug stores or online. Soft shoe inserts. Over-the-counter accommodative orthotics may also help bunion symptoms. This product is particularly helpful if bunion symptoms include pain that is under the ball of the foot. Orthotics with a slight medial longitudinal arch may be helpful for patients that have associated flatfoot deformity. These can be purchased at many sports stores, outdoors stores, or pharmacies. Bunion splints have often been used to treat the symptoms associated with hallux valgus. These splints are typically worn at night in an effort to reduce the bunion deformity. There is no evidence to suggest that these splints decrease the rate at which bunion deformities occur. There is also no evidence that clearly supports their effectiveness. However, some patients report good relief with the use of these splints.
Surgical Treatment
Bunions are painful deformities that develop when your big toe and first metatarsal slide out of alignment. Most of the time, this condition can be managed and your pain relieved using entirely conservative measures. Since this is a bone deformity, however, the problem can?t be truly corrected without a surgical procedure. Surgery for bunions realigns the displaced bones and restores the foot?s normal function.
Prevention
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.
A bunion is enlargement of bone or tissue that develops at the joint that connects your big toe to your foot. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and running. When the joint, called the metatarsophalangeal joint, or MTP joint, experiences abnormal, prolonged stress in terms of weight distribution or squeezing of the toes within the shoe, the result can be the deformity called a bunion. Generally, a bunion develops when, as a response to prolonged stress, your big toe begins bending toward your foot's smaller toes and puts pressure on your MTP joint, forcing it to bulge outward (the term "bunion" comes from the Latin word for "enlargement"). There is no "standard" bunion, however, but rather a complex range of joint, bone and tendon abnormalities that can cause variation in each bunion's make-up.
Causes
Abnormality in foot function, particularly a pronated foot. This is probably the most important and common causative factor. Family history of bunions. Narrow toed dress shoes and high heels may contribute to the formation of a bunion. Rheumatoid and Psoriatic arthritis. Genetic and neuromuscular disease (eg. Down's,Ehler-Danlos and Marfan's syndromes) resulting in muscle imbalance. Limb length inequality can cause a bunion on the longer limb. Generalized laxity of the ligaments. Trauma to or surgery on the soft tissue structures around the great toe (first metatarsal-phalangeal) joint.
Symptoms
If a foot bunion is developing, you may experience some of these symptoms. Bulge or bump on the outside of the base of your big toe. Swelling. Redness. Soreness. Thickening of the skin in that location. Corns or calluses. Limited movement of your big toe. Persistent or periodic pain. The pain you experience may be mild or severe. It may become increasingly difficult to walk in your normal shoes. The pressure on your other toes can cause your toenails to grow inward or your smaller toes to become bent.
Diagnosis
Although bunions are usually obvious from the pain and unusual shape of the toe, further investigation is often advisable. Your doctor will usually send you for X-rays to determine the extent of the deformity. Blood tests may be advised to see if some type of arthritis could be causing the pain. Based on this evaluation, your doctor can determine whether you need orthopaedic shoes, medication, surgery or other treatment.
Non Surgical Treatment
The initial treatment of a bunion should be non-operative. Symptoms can often be greatly improved with simple non-operative interventions. Non-operative treatment may include properly fitted shoes, Properly fitting comfort shoes with a wide non-constrictive toe box, especially one that is made out of a soft material such as leather, can be quite helpful in reducing the irritation over the prominent bunion. In some instances, it is helpful to have a shoemaker stretch the inside aspect of the shoe. Jamming a foot with a bunion into a constrictive shoe will likely lead to the development of uncomfortable symptoms. Bunion pads, Medial bunion pads may also be helpful in decreasing the symptoms associated with the bunion. These pads can be obtained at many drugstores. Essentially, they serve to lessen the irritation over the medial prominence and, thereby, decrease the associated inflammation This should be combined with comfortable non-constrictive shoes. A toe spacer placed between the great toe and the second toe can help to reduce the bunion deformity and, thereby, decrease the stretch on the medial tissue and the irritation associated with the bunion. Toe spacers can be obtained at most drug stores or online. Soft shoe inserts. Over-the-counter accommodative orthotics may also help bunion symptoms. This product is particularly helpful if bunion symptoms include pain that is under the ball of the foot. Orthotics with a slight medial longitudinal arch may be helpful for patients that have associated flatfoot deformity. These can be purchased at many sports stores, outdoors stores, or pharmacies. Bunion splints have often been used to treat the symptoms associated with hallux valgus. These splints are typically worn at night in an effort to reduce the bunion deformity. There is no evidence to suggest that these splints decrease the rate at which bunion deformities occur. There is also no evidence that clearly supports their effectiveness. However, some patients report good relief with the use of these splints.
Surgical Treatment
Bunions are painful deformities that develop when your big toe and first metatarsal slide out of alignment. Most of the time, this condition can be managed and your pain relieved using entirely conservative measures. Since this is a bone deformity, however, the problem can?t be truly corrected without a surgical procedure. Surgery for bunions realigns the displaced bones and restores the foot?s normal function.
Prevention
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.