Overview
When the big toe is misaligned, it creates an unnatural bump on the inside of the forefoot (see image below). In addition to being unsightly, the lump or bunion can cause pain and make buying shoes difficult. Some people are born predisposed to bunions. But most people acquire them over time from ill-fitting footwear that squeezes the big toe inward toward the other toes. About four out of five bunion pain patients are female, a near perfect fit for the bad shoe theory. The good news, Bunions can be corrected, often with better-fitting shoes and custom orthotics. There are also some cases that cause severe bunion pain and do not respond to conservative treatment. For those patients, bunion surgery called bunionectomy may be necessary.
Causes
There is much debate as to which is the major cause, but it is likely that your genetic makeup makes you more prone to a bunion or bunionette and that then wearing ill-fitting footwear causes them to develop. Studies have shown that in cultures where people don?t wear shoes but are habitually barefoot, there are very few cases of foot bunions indicating a strong correlation with shoe wear. They are more common in females, most likely due to choice of footwear.
Symptoms
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.
Diagnosis
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
If you suspect a bunion, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t try to treat the problem yourself, even by using conservative measures. Many conditions have similar symptoms, and only a professional can tell the difference. Once a diagnosis is obtained, it is essential to begin treatment immediately. Your podiatric physician will advise you on the most effective means. If caught early enough, good foot care, shoes that fit properly, and/or orthoses may eliminate the need for any further intervention. Certain over-the-counter remedies, such as felt or foam pads, applied to specific areas of the foot to relieve pressure and friction, will protect the bunion. Elevating the foot and icing the area for 20 minutes an hour may help to relieve pain.
Surgical Treatment
For very severe bunion deformities where there is considerable angulation between the first and second metatarsals an osteotomy of the metatarsal may not be sufficient and for these patients, the joint between the first metatarsal and the cuneiform bone is fused with screws, called the Lapidus procedure. This realigns the metatarsal completely and stabilizes the bone, preventing mobility and recurrent deformity.
When the big toe is misaligned, it creates an unnatural bump on the inside of the forefoot (see image below). In addition to being unsightly, the lump or bunion can cause pain and make buying shoes difficult. Some people are born predisposed to bunions. But most people acquire them over time from ill-fitting footwear that squeezes the big toe inward toward the other toes. About four out of five bunion pain patients are female, a near perfect fit for the bad shoe theory. The good news, Bunions can be corrected, often with better-fitting shoes and custom orthotics. There are also some cases that cause severe bunion pain and do not respond to conservative treatment. For those patients, bunion surgery called bunionectomy may be necessary.
Causes
There is much debate as to which is the major cause, but it is likely that your genetic makeup makes you more prone to a bunion or bunionette and that then wearing ill-fitting footwear causes them to develop. Studies have shown that in cultures where people don?t wear shoes but are habitually barefoot, there are very few cases of foot bunions indicating a strong correlation with shoe wear. They are more common in females, most likely due to choice of footwear.
Symptoms
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.
Diagnosis
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
If you suspect a bunion, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t try to treat the problem yourself, even by using conservative measures. Many conditions have similar symptoms, and only a professional can tell the difference. Once a diagnosis is obtained, it is essential to begin treatment immediately. Your podiatric physician will advise you on the most effective means. If caught early enough, good foot care, shoes that fit properly, and/or orthoses may eliminate the need for any further intervention. Certain over-the-counter remedies, such as felt or foam pads, applied to specific areas of the foot to relieve pressure and friction, will protect the bunion. Elevating the foot and icing the area for 20 minutes an hour may help to relieve pain.
Surgical Treatment
For very severe bunion deformities where there is considerable angulation between the first and second metatarsals an osteotomy of the metatarsal may not be sufficient and for these patients, the joint between the first metatarsal and the cuneiform bone is fused with screws, called the Lapidus procedure. This realigns the metatarsal completely and stabilizes the bone, preventing mobility and recurrent deformity.