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
A bunion is more common in women than men due to women wearing tighter fitting shoes. This condition can cause a variety of different soft tissue and bony complaints which may result in severe pain.
Symptoms
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.
Diagnosis
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Padding with a number of different materials (eg felt) to reduce pressure on the painful prominence of the bunion. Physical therapy can be used to help with the symptoms and improve the range of motion (this is particularly helpful if the pain is coming from inside the joint, rather than from shoe pressure). Manipulation of the joint can be used to help with this (manipulation will never correct the alignment of the joint). Any corns and calluses that are causing symptoms should be treated. The correct fitting of footwear is essential for anyone who is serious about doing something about their bunions and hallux valgus. It may be possible to have your shoes stretched over the area of the bunion to also relieve pressure. Foot orthotics may be useful in helping with the instability about the joint. They may be more helpful if there are other symptoms in the foot as well, as their use in "treating" bunions is controversial. They may play a role in slowing progression and in the prevention of bunions developing again after surgical correction. Exercises can be important in maintaining the mobility of the joint in those with bunions, this is especially important for the arthritic type pains that may be originating from inside the joint and for the prevention of these painful symptoms in the future.
Surgical Treatment
This involves surgically correcting the deformity and can involve a variety of different methods. However, outcomes can be variable. This is very dependant of the amount of damage to the joint and the procedure used to correct it. Removal of the bunion is performed using different methods that are out of the scope of this article. Unfortunately, bunions can recur following surgery, and even if it surgery is successful, around 30% of patients still report existing difficulties.