A bunion (also called Hallux Valgus) is a painful swelling caused by deformity of the big toe. As this swelling is caused by a bone it can be very unforgiving in shoes, which can rub on it causing pain, particularly formal foot shoes or high heels. Arthritis, or wearing tight or ill-fitting shoes over a period of many years, may increase the risk of bunions. However, they can have other causes. Bunions are more common in women and sometimes run in families.
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.
The most common symptoms of foot bunions are toe Position, the toe points inwards towards the other toes in the foot into the hallux adbucto valgus position and may even cross over the next toe. Bony Lump, swelling on the outer side of the base of the toe which protrudes outwards. Redness, over the bony lump where it becomes inflamed. Hard Skin, over the bony lump known as a callus. Pain, it is often painful around the big toe, made worse by pressure on the toe and weight bearing activities. Change in Foot Shape, Your whole foot may gradually change shape for example getting wider. Stiffness, the big toe often becomes stiff and may develop arthritis. Foot bunions are more common with increasing age. They develop gradually overtime from repeated force through the big toe and left untreated, become more pronounced with worsening symptoms.
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
Treatment of hallux valgus nearly always starts with adapting shoe wear to fit the foot. In the early stages of hallux valgus, converting from a shoe with a pointed toe to a shoe with a wide forefoot (or toe box) may arrest the progression of the deformity. Since the pain that arises from the bunion is due to pressure from the shoe, treatment focuses on removing the pressure that the shoe exerts on the deformity. Wider shoes reduce the pressure on the bunion. Bunion pads may reduce pressure and rubbing from the shoe. There are also numerous devices, such as toe spacers, that attempt to splint the big toe and reverse the deforming forces.
If conservative treatment doesn't provide relief from your symptoms, you may need surgery. The goal of bunion surgery is to relieve discomfort by returning your toe to the correct position. There are a number of surgical procedures for bunions, and no one technique is best for every problem. Surgical procedures for bunions might involve removing the swollen tissue from around your big toe joint. Straightening your big toe by removing part of the bone. Realigning the long bone between the back part of your foot and your big toe, to straighten out the abnormal angle in your big toe joint. Joining the bones of your affected joint permanently. It's possible you may be able to walk on your foot immediately after a bunion procedure. However, full recovery can take weeks to months. To prevent a recurrence, you'll need to wear proper shoes after recovery. It's unlikely that you'll be able to wear narrower shoes after surgery. Surgery isn't recommended unless a bunion causes you frequent pain or interferes with your daily activities. Talk to your doctor about what you can expect after bunion surgery.