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What
Is a Bunion?
A bunion is an enlargement of the joint at the base of the big
toe—the metatarsophalangeal (MTP) joint—that forms when the bone
or tissue at the big toe joint moves out of place. This forces the toe
to bend toward the others, causing an often painful lump of bone on
the foot. Since this joint carries a lot of the body’s weight while
walking, bunions can cause extreme pain if left untreated. The MTP
joint itself may become stiff and sore, making even the wearing of
shoes difficult or impossible. Bunions– from the Latin
"bunio," meaning enlargement–can also occur on the outside
of the foot along the little toe, where it is called a
"bunionette" or "tailor’s bunion."
Symptoms
- Development of a firm bump on the outside edge of
the foot, at the base of the big toe.
- Redness, swelling, or pain at or near the MTP
joint.
- Corns or other irritations caused by the overlap
of the first and second toes.
- Restricted or painful motion of the big toe.
How Do You Get a Bunion?
Bunions form when the normal balance of forces that is exerted on the
joints and tendons of the foot becomes disrupted. This can lead to
instability in the joint and cause the deformity. They are brought
about by years of abnormal motion and pressure over the MTP joint.
They are, therefore, a symptom of faulty foot development and are
usually caused by the way we walk, and our inherited foot type, our
shoes, or other sources.
Although bunions tend to run in families, it is the foot type that is
passed down—not the bunion. Parents who suffer from poor foot
mechanics can pass their problematic foot type on to their children,
who, in turn, are also prone to developing bunions. The abnormal
functioning caused by this faulty foot development can lead to
pressure being exerted on and within the foot, often resulting in bone
and joint deformities such as bunions and hammertoes.
Other causes of bunions are foot injuries, neuromuscular disorders, or
congenital deformities. People who suffer from flat feet or low arches
are also prone to developing these problems, as are arthritic patients
and those with inflammatory joint disease. Occupations that place
undue stress on the feet are also a factor; ballet dancers, for
instance, often develop the condition.
Wearing shoes that are too tight or cause the toes to be squeezed
together is also a common factor, one that explains the high
prevalence of the disorder among women.
What Can You Do For Relief?
- Apply a commercial, nonmedicated bunion pad
around the bony prominence.
- Wear shoes with a wide and deep toe box.
- If your bunion becomes inflamed and painful,
apply ice packs several times a day to reduce swelling.
- Avoid high-heeled shoes over two inches tall.
- See your podiatric physician if pain persists.
Conservative Treatment For Bunion Pain
Treatment options vary with the type and severity of each bunion,
although identifying the deformity early in its development is
important in avoiding surgery. Podiatric medical attention should be
sought at the first indication of pain or discomfort because, left
untreated, bunions tend to get larger and more painful, making
nonsurgical treatment less of an option.
The primary goal of most early treatment options is to relieve
pressure on the bunion and halt the progression of the joint
deformity. A podiatric physician may recommend these treatments:
- Padding & Taping
Often the first step in a treatment plan,
padding the bunion minimizes pain and allows the patient to
continue a normal, active life. Taping helps keep the foot in a
normal position, thus reducing stress and pain.
- Medication
Anti-inflammatory drugs and cortisone injections
are often prescribed to ease the acute pain and inflammations
caused by joint deformities.
- Physical Therapy
Often used to provide relief of the inflammation
and from bunion pain. Ultrasound therapy is a popular technique
for treating bunions and their associated soft tissue involvement.
- Orthotics
Shoe inserts may be useful in controlling foot
function and may reduce symptoms and prevent worsening of the
deformity.
When early treatments fail or the bunion progresses
past the threshold for such options, podiatric surgery may become
necessary to relieve pressure and repair the toe joint.
Surgical Options
Several surgical procedures are available to the podiatric physician
The surgery will remove the bony enlargement, restore the normal
alignment of the toe joint, and relieve pain.
A simple bunionectomy, in which only the bony prominence is removed,
may be used for the less severe deformity. Severe bunions may require
a more involved procedure, which includes cutting the bone and
realigning the joint.
Recuperation takes time, and swelling and some discomfort are common
for several weeks following surgery. Pain, however, is easily managed
with medications prescribed by your podiatric physician
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