A bunion looks like a bump on the inside of the foot where the big toe joins the foot. Over time, the bunion gets worse. The big toe starts to lean toward neighboring toes instead of pointing straight ahead. (The scientific name for this is hallux valgus or hallux abducto valgus.) The bump is a sign that the bones of the foot are out of alignment. While shoes with high heels or pointed toes may cause the joint to ache, they don't cause bunions. Most often they are due to an inherited foot structure. The tendons and ligaments that hold bones and muscles together at the joint are not working as they should. This structure makes it more likely that a person will develop a bunion.
High heels can exacerbate a potential bunion problem because they tip the body?s weight forward, forcing the toes into the front of the shoe. This may help to explain why bunions are 10 times more common in women than in men. People in occupations such as teaching and nursing, that involve a lot of standing and walking, are susceptible to bunions. Ballet dancers, whose feet suffer severe repetitive stress, are also amongst those who experience bunions. Women can sometimes develop bunions and other foot problems during pregnancy because hormonal changes loosen the ligaments and flatten the feet. Bunions are also associated with arthritis, which damages the cartilage within the joint.
If a foot bunion is developing, you may experience some of these symptoms. Bulge or bump on the outside of the base of your big toe. Swelling. Redness. Soreness. Thickening of the skin in that location. Corns or calluses. Limited movement of your big toe. Persistent or periodic pain. The pain you experience may be mild or severe. It may become increasingly difficult to walk in your normal shoes. The pressure on your other toes can cause your toenails to grow inward or your smaller toes to become bent.
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.
Non Surgical Treatment
Wear comfortable shoes that don't squeeze your toes together. Sandals are ideal in warm weather. Cushioning the bunion with a donut-shaped bunion pad sold at drugstores can prevent any direct rubbing against your shoes. Have your shoes stretched to give your foot more room or consider switching to footwear customized to relieve pressure on the affected area. Soak your foot in warm water to help lessen the pain after a day on your feet. Apply ice packs several times a day to reduce swelling of painful and inflamed bunions. Take aspirin or ibuprofen for the inflammation and pain, and try supplementing with anti-inflammatory herbs such as ginger and turmeric (these work more slowly than the drugs). See a podiatrist for specially fitted shoes or orthotic devices that may help. Sometimes, surgery is necessary. Seek a second opinion before scheduling any operation.
Surgery may be recommended for some bunions, but only when symptoms are severe enough to warrant such intervention. Surgery for a bunion, called a bunionectomy, is done in hospital usually under general anaesthesia. The surgeon can often realign the bone behind the big toe by cutting the ligaments at the joint. For a severe bunion, you may need to have the bone cut in a technique called an osteotomy. Wires or screws may be inserted to keep the bones in line, and excess bone may be shaved off or removed. Potential complications of surgery include recurrence of the bunion, inadequate correction, overcorrection (the toe now points inwards), continued pain, and limited movement of the big toe.
Choosing footwear that fits correctly, especially low heeled shoes with plenty of space for the toes, is one of the main ways that bunions can be prevented. Always stand when trying on shoes to ensure they still fit comfortably when the foot expands under your body weight. Try shoes on both feet, and select the size appropriate for your larger foot. Use an extra insole if one shoe is looser than the other. Do not cramp the larger foot. People prone to flat-footedness should consider the use of arch supports, orthotic shoe inserts or special orthotic shoes to prevent or delay the development of bunions.