Overview
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly. Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.
Causes
Bunions are not inherited, but do tend to run in families. What is inherited is the poor or faulty foot type, that mechanically can lead to the instability around the joint that will eventually lead to bunions, how soon, how quickly and how bad they are or become is assumed to be very dependant on the footwear. A number of other factors are known to play a role in the cause of bunions and hallux valgus. Bunions can follow foot injuries and develop in those with neuromuscular problems. Those with flat feet or pronated feet appear to be more prone to the instability about the joint and have a higher incidence of bunions. Some activities (eg ballet dancing) puts added pressure on the joint and may increase the chance of bunions developing.
Symptoms
In addition to the typical bump, signs of bunions can include red, calloused skin along the foot at the base of the big toe. With bunions, you may also develop calluses on the big toe, sores between the toes, ingrown toenail, and restricted motion of the toe. Some bunions are small and painless and some are large and extremely painful. Pressure from shoes worsens the problem.
Diagnosis
Bunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may arrange for x-rays to be taken to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike, some bunions progress more rapidly than others. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.
Non Surgical Treatment
Somtimes observation of the bunion is all that?s needed. A periodic exam and x-ray can determine if your bunion deformity is advancing. Measures can then be taken to reduce the possibility of permanent damage to your joint. In many cases, however, some type of treatment is needed. Conservative treatments may help reduce the pain of a bunion. These options include changes in shoe-wear. Wearing the right kind of shoes is very important. Choose shoes with a large toe box and avoid narrow high heeled shoes which may aggravate the condition. Padding. Pads can be placed over the area to reduce shoe pressure. Medication. Nonsteroidal anti-inflammatory drugs may help reduce inflammation and reduce pain. Injection therapy. Injection of steroid medication may be used to treat inflammation that causes pain and swelling especially if a fluid filled sac has developed about the joint. Orthotic shoe inserts. By controlling the faulty mechanical forces the foot may be stabilized so that the bunion becomes asymptomatic.
Surgical Treatment
Bunion surgery is usually done as an out patient procedure, so the patient does not have to stay in hospital overnight although it is usually performed under a general anesthetic. The procedure involves the surgeon making a cut on the inside of the big toe joint and removing excess bone whilst also repositioning ligaments and tendons. The joint may be fixed with screws or wires, which may be dissolve, or may be removed at a later date or in some cases, remain in the foot permanently. After the operation the foot will be immobilized, often in a cast for 4 to 8 weeks to keep the bones in alignment. Crutches will usually be issued to help the patient get around. After this period, the foot will be assessed to check the bones have healed correctly. At which point full weight bearing may be gradually introduced.
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly. Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.
Causes
Bunions are not inherited, but do tend to run in families. What is inherited is the poor or faulty foot type, that mechanically can lead to the instability around the joint that will eventually lead to bunions, how soon, how quickly and how bad they are or become is assumed to be very dependant on the footwear. A number of other factors are known to play a role in the cause of bunions and hallux valgus. Bunions can follow foot injuries and develop in those with neuromuscular problems. Those with flat feet or pronated feet appear to be more prone to the instability about the joint and have a higher incidence of bunions. Some activities (eg ballet dancing) puts added pressure on the joint and may increase the chance of bunions developing.
Symptoms
In addition to the typical bump, signs of bunions can include red, calloused skin along the foot at the base of the big toe. With bunions, you may also develop calluses on the big toe, sores between the toes, ingrown toenail, and restricted motion of the toe. Some bunions are small and painless and some are large and extremely painful. Pressure from shoes worsens the problem.
Diagnosis
Bunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may arrange for x-rays to be taken to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike, some bunions progress more rapidly than others. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.
Non Surgical Treatment
Somtimes observation of the bunion is all that?s needed. A periodic exam and x-ray can determine if your bunion deformity is advancing. Measures can then be taken to reduce the possibility of permanent damage to your joint. In many cases, however, some type of treatment is needed. Conservative treatments may help reduce the pain of a bunion. These options include changes in shoe-wear. Wearing the right kind of shoes is very important. Choose shoes with a large toe box and avoid narrow high heeled shoes which may aggravate the condition. Padding. Pads can be placed over the area to reduce shoe pressure. Medication. Nonsteroidal anti-inflammatory drugs may help reduce inflammation and reduce pain. Injection therapy. Injection of steroid medication may be used to treat inflammation that causes pain and swelling especially if a fluid filled sac has developed about the joint. Orthotic shoe inserts. By controlling the faulty mechanical forces the foot may be stabilized so that the bunion becomes asymptomatic.
Surgical Treatment
Bunion surgery is usually done as an out patient procedure, so the patient does not have to stay in hospital overnight although it is usually performed under a general anesthetic. The procedure involves the surgeon making a cut on the inside of the big toe joint and removing excess bone whilst also repositioning ligaments and tendons. The joint may be fixed with screws or wires, which may be dissolve, or may be removed at a later date or in some cases, remain in the foot permanently. After the operation the foot will be immobilized, often in a cast for 4 to 8 weeks to keep the bones in alignment. Crutches will usually be issued to help the patient get around. After this period, the foot will be assessed to check the bones have healed correctly. At which point full weight bearing may be gradually introduced.