Overview
A bunion forms when the bursa (a sac of fluid at friction points between the tendons and bone in some areas and between bone and the skin in others) becomes inflamed along the edge of the joint at the base of the big toe. There are two types of bunions. The acute bunion causes the sharper pain. It develops from a bursitis, a sudden outcropping of a fluid-filled sac. An acute bunion can progress into the second type of bunion, the hallux valgus, a chronic but often painless deformity involving permanent rigidity of the bones. Bunions can form in any part of the foot but occur most often at the big toe joint, where the first metatarsal bone abuts the proximal phalanx of the big toe. Women are more likely than men to get bunions because of the misshapen footwear and elevated heels they wear.
Causes
Wearing footwear that is too tight or causing the toes to be squeezed together are the most commonly blamed factor for the cause of bunions and hallux valgus and is undoubtedly the main contributing factor. This probably is the reason for the higher prevalence of bunions among women. However, studies of some indigenous populations that never wear footwear, show that they also get bunions but they are very uncommon. As they do get bunions, factors other than footwear must play a role in the cause, even though footwear is the main culprit for providing the pressure that causes the symptoms.
Symptoms
Corns and calluses may occur on the soles of the feet, in between toes and on the bunion joint. Stiffness can occur at the big toe due to secondary arthritis, this is known as Hallux Rigidus. Other foot conditions can occur such as in growing toenails and in severe cases the bunion joint may have a fluid filled sack called a bursitis. This can be very painful and can become infected.
Diagnosis
A simple visual exam is all it will take for your doctor to determine whether you have a bunion. He or she may also ask you to move your big toe in order to ascertain your range of motion. Your doctor may also look for any inflammation, redness, or pain. X-rays can help your doctor determine the severity and cause of the bunion. Your doctor may also ask you questions about your footwear, the symptoms you are experiencing, and if other family members also suffer from the condition. All these factors will help him or her diagnose you properly.
Non Surgical Treatment
Bunions are progressive problems, meaning they tend to get worse over time. Sometimes severe-looking bunions don't hurt much, and sometimes relatively modest-looking bunions hurt a great deal. Thus, treatment varies depending upon a patient's symptoms. You can often improve the discomfort of bump pain by a change to more proper shoes. Alternatively, alterations to existing shoes may improve pain associated with bunions. Accommodative padding, shields and various over-the-counter and custom-made orthopaedic appliances can also alleviate bunion pain. Anti-inflammatory medications, steroid injections, physiotherapy, massage, stretching, acupuncture and other conservative treatment options may be recommended by your podiatric physician to calm down an acutely painful bunion. Long term, orthoses (orthotics) can address many of the mechanical causes of a bunion. Thus, while orthoses don't actually correct a bunion deformity, if properly designed and made, they can slow the progression of bunions. They can also be made to redistribute weight away from pain in the ball of the foot, which often accompanies bunion development. Padding, latex moulds and other accommodative devices may also be effective. While they don't correct the misalignment in the bones, they may alleviate pain. Often, though, when conservative measures fail to alleviate pain associated with the bunion, when you start to limit the types of activities you perform, when it's difficult to find comfortable shoes, and when arthritis changes how you walk, surgery may be the best alternative.
Surgical Treatment
Procedures are designed and chosen to correct a variety of pathologies that may be associated with the bunion. For instance, procedures may address some combination of removing the abnormal bony enlargement of the first metatarsal, realigning the first metatarsal bone relative to the adjacent metatarsal bone, straightening the great toe relative to the first metatarsal and adjacent toes, realigning the cartilagenous surfaces of the great toe joint, addressing arthritic changes associated with the great toe joint, repositioning the sesamoid bones beneath the first metatarsal bone, shortening, lengthening, raising, or lowering the first metatarsal bone, and correcting any abnormal bowing or misalignment within the great toe. Connecting two parallel long bones side by side by Syndesmosis Procedure. At present there are many different bunion surgeries for different effects. The age, health, lifestyle and activity level of the patient may also play a role in the choice of procedure. Traditional bunion surgery can be performed under local, spinal or general anesthetic. In the case of laser surgery, a narcotic analgesic is typically used.[5] The trend has moved strongly toward using the less invasive local anesthesia over the years. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility. An orthopedic cast is much less common today as newer, more stable procedures and better forms of fixation (stabilizing the bone with screws and other hardware) are used. Hardware may even include absorbable pins that perform their function and are then broken down by the body over the course of months.
A bunion forms when the bursa (a sac of fluid at friction points between the tendons and bone in some areas and between bone and the skin in others) becomes inflamed along the edge of the joint at the base of the big toe. There are two types of bunions. The acute bunion causes the sharper pain. It develops from a bursitis, a sudden outcropping of a fluid-filled sac. An acute bunion can progress into the second type of bunion, the hallux valgus, a chronic but often painless deformity involving permanent rigidity of the bones. Bunions can form in any part of the foot but occur most often at the big toe joint, where the first metatarsal bone abuts the proximal phalanx of the big toe. Women are more likely than men to get bunions because of the misshapen footwear and elevated heels they wear.
Causes
Wearing footwear that is too tight or causing the toes to be squeezed together are the most commonly blamed factor for the cause of bunions and hallux valgus and is undoubtedly the main contributing factor. This probably is the reason for the higher prevalence of bunions among women. However, studies of some indigenous populations that never wear footwear, show that they also get bunions but they are very uncommon. As they do get bunions, factors other than footwear must play a role in the cause, even though footwear is the main culprit for providing the pressure that causes the symptoms.
Symptoms
Corns and calluses may occur on the soles of the feet, in between toes and on the bunion joint. Stiffness can occur at the big toe due to secondary arthritis, this is known as Hallux Rigidus. Other foot conditions can occur such as in growing toenails and in severe cases the bunion joint may have a fluid filled sack called a bursitis. This can be very painful and can become infected.
Diagnosis
A simple visual exam is all it will take for your doctor to determine whether you have a bunion. He or she may also ask you to move your big toe in order to ascertain your range of motion. Your doctor may also look for any inflammation, redness, or pain. X-rays can help your doctor determine the severity and cause of the bunion. Your doctor may also ask you questions about your footwear, the symptoms you are experiencing, and if other family members also suffer from the condition. All these factors will help him or her diagnose you properly.
Non Surgical Treatment
Bunions are progressive problems, meaning they tend to get worse over time. Sometimes severe-looking bunions don't hurt much, and sometimes relatively modest-looking bunions hurt a great deal. Thus, treatment varies depending upon a patient's symptoms. You can often improve the discomfort of bump pain by a change to more proper shoes. Alternatively, alterations to existing shoes may improve pain associated with bunions. Accommodative padding, shields and various over-the-counter and custom-made orthopaedic appliances can also alleviate bunion pain. Anti-inflammatory medications, steroid injections, physiotherapy, massage, stretching, acupuncture and other conservative treatment options may be recommended by your podiatric physician to calm down an acutely painful bunion. Long term, orthoses (orthotics) can address many of the mechanical causes of a bunion. Thus, while orthoses don't actually correct a bunion deformity, if properly designed and made, they can slow the progression of bunions. They can also be made to redistribute weight away from pain in the ball of the foot, which often accompanies bunion development. Padding, latex moulds and other accommodative devices may also be effective. While they don't correct the misalignment in the bones, they may alleviate pain. Often, though, when conservative measures fail to alleviate pain associated with the bunion, when you start to limit the types of activities you perform, when it's difficult to find comfortable shoes, and when arthritis changes how you walk, surgery may be the best alternative.
Surgical Treatment
Procedures are designed and chosen to correct a variety of pathologies that may be associated with the bunion. For instance, procedures may address some combination of removing the abnormal bony enlargement of the first metatarsal, realigning the first metatarsal bone relative to the adjacent metatarsal bone, straightening the great toe relative to the first metatarsal and adjacent toes, realigning the cartilagenous surfaces of the great toe joint, addressing arthritic changes associated with the great toe joint, repositioning the sesamoid bones beneath the first metatarsal bone, shortening, lengthening, raising, or lowering the first metatarsal bone, and correcting any abnormal bowing or misalignment within the great toe. Connecting two parallel long bones side by side by Syndesmosis Procedure. At present there are many different bunion surgeries for different effects. The age, health, lifestyle and activity level of the patient may also play a role in the choice of procedure. Traditional bunion surgery can be performed under local, spinal or general anesthetic. In the case of laser surgery, a narcotic analgesic is typically used.[5] The trend has moved strongly toward using the less invasive local anesthesia over the years. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility. An orthopedic cast is much less common today as newer, more stable procedures and better forms of fixation (stabilizing the bone with screws and other hardware) are used. Hardware may even include absorbable pins that perform their function and are then broken down by the body over the course of months.