A bunion is the enlargement of the joint at the base of the big toe. It occurs as a result of the misalignment of the bones of the big toe. This leads to stretching of the ligaments and tendons around the big toe joint and causes soft tissue over the joint to become inflamed and painful. There may be additional bone formation (exostosis) in the joint and the skin around the joint may become red and tender. Over time the cartilage in the joint can break down, leading to arthritis.
There are many factors which can contribute to the development of a bunion. The common causes are genetic factors, poor foot mechanics, high-heeled or narrow footwear and trauma to the toe. It is believed that constant stress on the joint of the big toe causes mild displacement of the bones and the joint, along with thickening of the tissues and a change in the pull of the muscles. This can result in a degree of arthritis of the joint, and over time, further displacement of the toe. This may lead to pain, difficultly with fitting shoes and corns/calloused lesions due to excess pressure on the smaller digits.
Your bunion may not cause any symptoms. Or you may have pain in your big toe, red or irritated skin over the bunion, and swelling at the base of the big toe. The big toe may point toward the other toes and cause problems in other toes, such as hammer toe . A bunionette can cause similar symptoms at the base of the little toe.
Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.
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.
Severe cases may require, along with surgery, cast immobilization and prolonged avoidance of weight-bearing activity. You should know that undergoing surgery for this health problem does not guarantee a cure or even a beneficial health outcome. Bunions, like many other foot conditions, should always be approached from a prevention standpoint, or therapy should be directed at slowing the progression of your deformity.