A bunion is a bone deformity caused by an enlargement
of the joint at the base and side of the big toe
(metatarsophalangeal joint). Bunions form when
the toe moves out of place. The enlargement and
its protuberance cause friction and pressure as
they rub against footwear. Over time, the movement
of the big toe angles in toward the other toes,
sometimes overlapping a third toe (known as Hallux
Valgus). The growing enlargement or protuberance
then causes more irritation or inflammation. In
some cases, the big toe moves toward the second
toe and rotates or twists, which is known as Hallus
Abducto Valgus. Bunions can also lead to other
toe deformities, such as hammertoes.
Many people with bunions suffer from discomfort
and pain from the constant irritation, rubbing,
and friction of the enlargement against shoes.
The skin over the toe becomes red and tender.
Because this joint flexes with every step, the
bigger the bunion gets, the more it hurts to walk.
Over time, bursitis or arthritis may set in, the
skin on the bottom of the foot may become thicker,
and everyday walking may become difficult—all
contributing
to chronic pain.
Wearing shoes that are too tight is the leading
cause of bunions. Bunions are not hereditary,
but they do tend to run in families, usually because
of a faulty foot structure. Foot injuries, neuromuscular
problems, flat feet, and pronated feet
can contribute to their formation. It is estimated
that bunions occur in 33 percent of the population
in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do
not resolve by themselves. The goal for bunion
treatment is twofold: first, to relieve the pressure
and pain cause by irritations, and second to stop
any progressive growth of the enlargement. Commonly
used methods for reducing pressure and pain caused
by bunions include:
* The use of protective padding, often made from
felt material, to eliminate the friction against
shoes and help alleviate inflammation and skin
problems.
* Removal of corns and calluses on the foot.
* Changing to carefully-fitted footwear designed
to accommodate the bunion and not contribute toward
its growth.
* Orthotic devices—both over-the-counter and custom
made—to help stabilize the joint and place the
foot in the correct position for walking and standing.
* Exercises to maintain joint mobility and prevent
stiffness or arthritis.
* Splints for nighttime wear to help the toes
and joint align properly. This is often recommended
for adolescents with bunions, because their bone
development may still be adaptable.
Surgical Treatment
Depending on the size of the enlargement, misalignment
of the toe, and pain experienced, conservative
treatments may not be adequate to prevent progressive
damage from bunions. In these cases, bunion surgery,
known as a bunionectomy, may be advised to remove
the bunion and realign the toe.
