Bunions (hallux valgus) are often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion's "bump." Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people never have symptoms.
Perhaps the most frequent cause of bunion development is the wearing of shoes with tight, pointed toes, or with high heels that shift all of your body's weight onto your toes and also jam your toes into your shoes' toe boxes. It's estimated that more than 50 percent of women have bunions caused by high-heel shoes, and that nine out of 10 people who develop bunions are women. Bunions can also develop on your little toes, in which case they are called bunionettes or tailor's bunions.
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.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Most bunions can be treated without surgery. The first step for treating bunions is to ensure that your shoes fit correctly. Often good footwear is all that is needed to alleviate the problem. Shoes that are wide enough to avoid pressure on the bunion are the obvious first step. Look for shoes with wide insteps and broad toes and definitely no high heels. Sometimes, you can get your existing shoes stretched out by a shoe repairer. Seek advice from a podiatrist. Pads and toe inserts. Protective bunion pads may help to cushion the joint and reduce pain. Toe inserts are available that splint the toes straight. It may be recommended that you wear some orthotics to improve your foot position when walking. Medicines. Some people find anti-inflammatory medicines, such as ibuprofen or aspirin, or paracetamol help ease the pain of their bunions.
The choice of surgical procedures (bunionectomy) is based on a biomechanical and radiographic examination of the foot. Because there is actual bone displacement and joint adaptation, most successful bunionectomies require cutting and realigning the 1st metatarsal (an osteotomy). Simply "shaving the bump" is often inadequate in providing long-term relief of symptoms and in some cases can actually cause the bunion to progress faster. The most common procedure performed for the correction of bunions is the 1st metatarsal neck osteotomy, near the level of the joint. This refers to the anatomical site on the 1st metatarsal where the actual bone cut is made. Other procedures are preformed in the shaft of the metatarsal bone (see procedures preformed in the shaft of the metatarsal) and still other procedures are selected by the surgeon that are preformed in the base of the metatarsal bone (see surgeries preformed in the base of the metatarsal).
Here are some tips to help you prevent bunions. Wear shoes that fit well. Use custom orthotic devices. Avoid shoes with small toe boxes and high heels. Exercise daily to keep the muscles of your feet and legs strong and healthy. Follow your doctor?s treatment and recovery instructions thoroughly. Unfortunately, if you suffer from bunions due to genetics, there may be nothing you can do to prevent them from occurring. Talk with your doctor about additional prevention steps you can take, especially if you are prone to them.