The term bunion as it is popularly used describes a variety of deformities involving a painful prominence and swelling at the base of the big toe. Orthopaedists use additional terms to describe the different deformities. The condition in which the big toe deviates from the normal position toward the direction of the second toe is referred to as hallux valgus. The word bunion refers specifically to the prominence made of bone and at times an inflamed bursa. This bursa develops on the first metatarsal head at the base of the big toe because of this bony prominence. Although a bunion may develop without hallux valgus, for the purposes of this discussion, the term bunion will include both. Dorsal bunions, are a separate entity, in which the prominence appears on the top of the base of the toe-often the result of an arthritic joint. Causes
The main cause of bunions is a mechanical imbalance in the feet which is usually inherited. The mechanical imbalance is known as overpronation, where the feet roll in towards the arch and big toe. This added weight and stress transfer towards the big toe, causes instability in the structures of this area and a bunion develops.
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
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.
Non Surgical Treatment
Before treatment of a painful bunion can begin, medical evaluation is needed. There are a number of other causes of pain in the big toe such as osteoarthritis, rheumatoid arthritis, infection and gout. Circulatory problems not only cause pain, but may also cause serious complications if surgery is attempted. Diabetes and cigarette smoking may diminish healing potential and increase the risk of infection.
Surgical Treatment
Conservative bunion treatment methods help to reduce the symptoms but they cannot undo changes in the bone to fully correct the condition. If the pain becomes severe and it starts to affect your daily life, then foot bunion surgery may be the best option to correct a hallux abducto valgus. There are a number of different surgical options, depending on the severity of the bony deformity. The two most common types of surgery are Osteotomy. This is the most common type pf surgery and involves removing part of the bony lump and realigning the toes. It is also known as a bunionectomy or exostectomy. The ligaments around the big toe may also need realigning and this will be done at the same time if necessary. Fusion.This is where the joint at the base of the big toe (metatarsophalangeal joint) is fused together, known as an arthrodesis. This is only indicated in severe cases or if other treatments have failed as it severely limits the movement of the big toe.
Prevention
The best way to reduce your chances of developing bunions is to wear shoes that fit properly. Shoes that are too tight or have high heels can force your toes together. Bunions are rare in populations that don?t wear shoes. Make sure your shoes are the correct size and that there's enough room to move your toes freely. It's best to avoid wearing shoes with high heels or pointy toes.