If you?ve developed a solid bump at the base of your big toe along with pain and swelling, it?s possible that you have a bunion. According to the American Podiatric Medical Association (APMA) 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.? Causes
No one single cause has been proven. There are a number of causes, and though shoes can exacerbate the problem, bunions do occur in societies that don?t wear them. We walk on the same type of ground all the time, whereas the human foot was actually designed to adapt to varying terrains. In a sense, a bunion is a type of repetitive strain injury. And like repetitive strain injury, some people are more prone to it than others. One theory, though it remains unproven, is that bunions are caused by one or both of the following. Because the foot wasn?t designed to constantly walk on a level surface, the ball of the big toe is slightly lower than the ball of the rest of your foot. When your foot meets the ground, the ball of the big toe is pushed up, and the big toe joint can?t bend as well as it was designed to. In order for the big toe joint to bend fully as you walk, your foot rolls slightly over to the side (this is also why people with hallux valgus often get hard skin). Also, if your midtarsal joint tends to move from side to side more than it does up and down, the arch in your foot collapses as your foot rolls in. This also makes you more prone to developing bunions. Such problems can be exacerbated by tight footwear. Slip-on shoes can make matters worse. Because they have to be tighter to stay on your feet, you automatically have less room for your toes. And with nothing to hold your foot in place, your toes often slide to the end where they?re exposed to lots of pressure. Likewise, high heels throw more weight onto the ball of the foot, putting your toes under further pressure. If you haven?t got a bunion by adulthood and you later develop one, there could be some underlying arthritis.
Symptoms
With Bunions, a person will have inflammation, swelling, and soreness on the side surface of the big toe. Corns most commonly are tender cone-shaped patches of dry skin on the top or side of the toes. Calluses will appear on high-pressure points of the foot as thick hardened patches of skin.
Diagnosis
Looking at the problem area on the foot is the best way to discover a bunion. If it has the shape characteristic of a bunion, this is the first hint of a problem. The doctor may also look at the shape of your leg, ankle, and foot while you are standing, and check the range of motion of your toe and joints by asking you to move your toes in different directions A closer examination with weight-bearing X-rays helps your doctor examine the actual bone structure at the joint and see how severe the problem is. A doctor may ask about the types of shoes you wear, sports or activities (e.g., ballet) you participate in, and whether or not you have had a recent injury. This information will help determine your treatment.
Non Surgical Treatment
In most cases the symptoms of bunions can be reduced or relieved without surgery. Reducing pressure on the bunion is the first step in reducing the pain associated with the condition. Wearing correctly fitting shoes is important in achieving this. A referral to a podiatrist may be made in order to assess the need for special orthotic devices, such as custom-made arch supports and shoe inserts (eg: metatarsal pad or bar). These can help to relieve tension on the base of the big toe and help prevent flat-footedness. Specific exercises and bunion pads available over-the-counter at pharmacies may also be of benefit. Anti-inflammatory medicines can help to ease pain in the short term. Steroid injections may be used to relieve severe pain. If a sufficient reduction in symptoms is not achieved by non-surgical treatment, then surgery may be recommended.
Surgical Treatment
Surgery might be recommended if non-surgical treatments fail to provide relief, and you are having trouble walking or are in extreme pain. Surgery can be used to return the big toe to its correct anatomical position. During surgery, bones, ligaments, tendons, and nerves are put back into correct order, and the bump is removed. Many bunion correction procedures can be done on a same-day basis. The type of procedure will depend on your physical health, the extent of the foot deformity, your age, and your activity level. The recovery time will depend on which procedure or procedures are performed. Surgery may be recommended to correct a tailor?s bunion, but is unlikely to be recommended for an adolescent bunion.
Prevention
To minimize the chance of developing bunions, never force your feet into shoes that don?t fit. Choose a shoe that conforms to the shape of your foot. Opt for shoes with wider insteps, broad toes, and soft soles. Shoes that are short, tight, or sharply pointed should be avoided.