Overview
A bunion develops when the joint at the base of the big toe becomes swollen and most likely painful. The American Academy of Orthopaedic Surgeons suggests these ways to ease bunion pain. Make sure shoes fit properly and comfortably, and mold to the shape of your feet. Opt for shoes with a soft sole, wide toe box and wide instep. Avoid heels of more than 2 1/4 inches, those that are too tight, and shoes with pointy, narrow toes. To accommodate a bunion, wear shoes that are a bit big, or have your shoes professionally stretched. Place a protective cushioned pad over the bunion.
Causes
No single cause or set of causes for bunions has been identified, although gender-women develop them more frequently than men-and heredity play a role. In addition, the foot gradually widens with age as the ligaments that connect the bones in the forefoot become more lax. Contrary to what many people believe, ill-fitting footwear is not the cause of bunions. In fact, bunions are found in populations all over the world, including among those who never wear shoes. Shoes that are too tight can, however, contribute to the progression of the condition. Bunions are often bilateral, that is, appearing in both feet. Although bunions are usually seen in people who are middle-aged or older, there are adolescents who are diagnosed with the condition, usually the result of a congenital problem.
Symptoms
Pain in the toe joint and surrounding area. Painful to touch or press, and when walking. Growth of a bony lump (exostosis) at the side of the big toe joint. Irritated skin around the bunion. Redness. Thickening of overlying skin. Blisters may form more easily. Deformed bones, joints and ligaments as the big toe shifts towards the other toes. As the big toe shifts, its base becomes more prominent, forming the bunion. Eventually the big toe is forced to lie over, or more commonly under, the second toe. The second toe of patients who have bunions commonly forms a hammer toe. Trouble with shoes. It is difficult to find shoes that fit properly. Bunions may force you to buy a larger size shoe to accommodate the width the bunion creates. Eventually it hurts to wear any shoe, or even walk barefoot.
Diagnosis
Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight. X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout , rheumatoid arthritis , or joint infection.
Non Surgical Treatment
There are many treatment options for bunions and they will vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time, how fast this happens may be a function of the fit of the footwear. The initial goal of treatment options is to relieve pressure on the bunion and any symptoms that may be present and to halt or slow the progression of the joint deformity. There is no effective may be "get rid off" a bunion without surgery. There are a number of things that individuals and Podiatrists can do to help the symptoms and slow (if not halt) progression.
Surgical Treatment
There are many different surgical procedures that can be performed. The decision to perform one type of surgery or another is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the big toe joint, and the space between the first and second metatarsals, which is called the intermetatarsal angle. It is very rare that a bunion can be treated by simply shaving down the bump of the bone. Invariably, the deformity will recur and both the bunion and the hallux valgus will return. Therefore, the shaving of the bunion, called an exostectomy, is performed in conjunction with a cut of the first metatarsal bone (which is called an osteotomy).
Prevention
Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family. Exercising your feet can strengthen them. Learn to pick up small objects, like a pencil or pebble, with your toes. Wear shoes that fit properly and don't cramp or pinch your toes. Women should avoid shoes with very high heels or pointed toes.
A bunion develops when the joint at the base of the big toe becomes swollen and most likely painful. The American Academy of Orthopaedic Surgeons suggests these ways to ease bunion pain. Make sure shoes fit properly and comfortably, and mold to the shape of your feet. Opt for shoes with a soft sole, wide toe box and wide instep. Avoid heels of more than 2 1/4 inches, those that are too tight, and shoes with pointy, narrow toes. To accommodate a bunion, wear shoes that are a bit big, or have your shoes professionally stretched. Place a protective cushioned pad over the bunion.
Causes
No single cause or set of causes for bunions has been identified, although gender-women develop them more frequently than men-and heredity play a role. In addition, the foot gradually widens with age as the ligaments that connect the bones in the forefoot become more lax. Contrary to what many people believe, ill-fitting footwear is not the cause of bunions. In fact, bunions are found in populations all over the world, including among those who never wear shoes. Shoes that are too tight can, however, contribute to the progression of the condition. Bunions are often bilateral, that is, appearing in both feet. Although bunions are usually seen in people who are middle-aged or older, there are adolescents who are diagnosed with the condition, usually the result of a congenital problem.
Symptoms
Pain in the toe joint and surrounding area. Painful to touch or press, and when walking. Growth of a bony lump (exostosis) at the side of the big toe joint. Irritated skin around the bunion. Redness. Thickening of overlying skin. Blisters may form more easily. Deformed bones, joints and ligaments as the big toe shifts towards the other toes. As the big toe shifts, its base becomes more prominent, forming the bunion. Eventually the big toe is forced to lie over, or more commonly under, the second toe. The second toe of patients who have bunions commonly forms a hammer toe. Trouble with shoes. It is difficult to find shoes that fit properly. Bunions may force you to buy a larger size shoe to accommodate the width the bunion creates. Eventually it hurts to wear any shoe, or even walk barefoot.
Diagnosis
Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight. X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout , rheumatoid arthritis , or joint infection.
Non Surgical Treatment
There are many treatment options for bunions and they will vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time, how fast this happens may be a function of the fit of the footwear. The initial goal of treatment options is to relieve pressure on the bunion and any symptoms that may be present and to halt or slow the progression of the joint deformity. There is no effective may be "get rid off" a bunion without surgery. There are a number of things that individuals and Podiatrists can do to help the symptoms and slow (if not halt) progression.
Surgical Treatment
There are many different surgical procedures that can be performed. The decision to perform one type of surgery or another is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the big toe joint, and the space between the first and second metatarsals, which is called the intermetatarsal angle. It is very rare that a bunion can be treated by simply shaving down the bump of the bone. Invariably, the deformity will recur and both the bunion and the hallux valgus will return. Therefore, the shaving of the bunion, called an exostectomy, is performed in conjunction with a cut of the first metatarsal bone (which is called an osteotomy).
Prevention
Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family. Exercising your feet can strengthen them. Learn to pick up small objects, like a pencil or pebble, with your toes. Wear shoes that fit properly and don't cramp or pinch your toes. Women should avoid shoes with very high heels or pointed toes.