A bunion (also called Hallux Valgus) is a painful swelling caused by deformity of the big toe. As this swelling is caused by a bone it can be very unforgiving in shoes, which can rub on it causing pain, particularly formal foot shoes or high heels. Arthritis, or wearing tight or ill-fitting shoes over a period of many years, may increase the risk of bunions. However, they can have other causes. Bunions are more common in women and sometimes run in families. Causes
Bunions develop when excess pressure is placed on the tendons and joints of the foot. As a result, the joints can become deformed and unstable. After years of pressure, the MTP joint suffers, leading to abnormal movement and bunions. Bunions are symptomatic of poor foot development (which can be genetic), walking habits, shoes, foot type and other reasons. Women often develop bunions as a result of tight shoes that squeeze the toes together. Bunions can also result from foot injuries, congenital deformities and neuromuscular disorders. Flat foot and low arch problems are often precursors to bunions, as are problems with serious arthritis or inflammatory joint disease. An overlap of the first and second toes often causes irritation and corns and can eventually lead to bunions. Poor motion of the big toe can also be a factor.
Symptoms
Red, thickened skin along the inside edge of the big toe. A bony bump at this site. Pain over the joint, which pressure from shoes makes worse. Big toe turned toward the other toes and may cross over the second toe.
Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).
Non Surgical Treatment
There is no way to eliminate existing bunions except to have them surgically removed. There are nonsurgical measures you can take to alleviate the pain and prevent your bunions from increasing in severity, and for that reason it's important to see your doctor before they become a serious problem. The more extensive your bunions are, the less effective nonsurgical treatments are. On the other hand, most bunions can be dealt with without surgery through wearing roomier, low-heel shoes, padding and taping your feet, using medications for pain control, going to physical therapy to relieve inflammation and wearing orthotics in your shoes to correct mechanical problems. Bunions that are not causing pain generally aren't appropriate for surgery. Roomier shoes. You should seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed. You should make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe. Make sure the ball of your foot fits comfortably in the widest part of the shoe. Feet normally swell during the course of the day, so shop for shoes at the end of the day, when your feet are at their largest. Don't be vain about your shoe size, sizes vary by brand, so concentrate on making certain your shoes are comfortable. Remember that your two feet are very likely to be different sizes and fit your shoe size to the larger foot. Low-heel shoes. High heels shift all your body weight onto your toes, increasing the pressure on your toes and their joints tremendously. Instead, wear shoes with low (less than two inches) or flat heels that fit your foot comfortably. Padding and Taping. Padding the bunion can minimize pain and allow you to walk more normally. Specially designed pads for this are available at most drugstores. Taping your foot can reduce stress and pain in it by helping it stay in a more normal position. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with pain and inflammation caused by your bunion. Cortisone injections may be prescribed for the same purpose. If your bunion is a consequence of arthritis in the MTP joint, your physician may prescribe medications for that. Physical Therapy. Ultrasound treatments and whirlpool baths can help reduce pain and inflammation in bunions and related tissues. Orthotics are shoe inserts that can help correct mechanical foot-motion problems to reduce pain and prevent worsening of your bunion. Other measures. Icing and elevating your foot when your bunion is painful may help. Having your shoes stretched at a shoe repair shop may help also.
Surgical Treatment
Surgery should only be considered for bunions that are painful, not for correction of the cosmetic appearance! The primary indication for operative intervention should be pain that is not relieved by appropriate non-operative management. Although symptom-free bunions can slowly increase in size over time surgical treatment is not recommended unless significant pain symptoms develop. The prolonged recovery time associated with most bunion operations, combined with the potential for complications means that patients should be extremely cautious of undergoing bunion surgery for purely cosmetic reasons.