A bunion is an abnormal bump, or bony enlargement that forms at the base of your big toe. In the early stages, the bunion may be small and the side of your foot may be slightly swollen. As it progresses, the bump gets larger and becomes increasingly painful. Your big toe may point towards your other toes, rather than straight. Shoes may be uncomfortable to wear and add to the irritation of the joint. Causes
Some people develop bunions from wearing shoes that do not fit correctly (especially high heels or narrow-toed shoes). For other people, bunions are caused by factors beyond their control. These can include a family history of a foot type that is susceptible to bunions, neuromuscular disorders, conditions affecting the joints (e.g., arthritis), severe injury to the foot, deformities at birth, problems that affect the way a person walks (e.g., rolling in at the ankles).
Symptoms
A bunion, also called a hallux valgus, is a bony prominence on the inside of the big toe, caused by a misalignment of the joint. The overlying skin maybe swollen, red and tender. Bunions are often painful and can limit what shoes you can wear.
Diagnosis
People with bunions may be concerned about the changing appearance of their feet, but it is usually the pain caused by the condition that leads them to consult their doctor. The doctor will evaluate any symptoms experienced and examine the affected foot for joint enlargement, tissue swelling and/or tenderness. They will also assess any risk factors for the condition and will ask about family history. An x-ray of the foot is usually recommended so that the alignment of big toe joint can be assessed. This would also allow any other conditions that may be affecting the joint, such as arthritis, to be seen.
Non Surgical Treatment
A bunion may only need to be treated if it's severe and causing significant pain and discomfort. The different treatments for bunions are described below. If possible, non-surgical treatment for bunions will be used, which your GP can discuss with you. Non-surgical treatments can ease the pain and discomfort caused by a bunion, but they can't change the shape of your foot or prevent a bunion from getting worse over time. Non-surgical treatments include painkillers, bunion pads, orthotics, wearing suitable footwear, These are discussed in more detail below. If your bunion is painful, over-the-counter painkillers such as paracetamol or ibuprofen may be recommended.Bunion pads may also ease the pain of a bunion. Reusable bunion pads, made of either gel or fleece, are available over the counter from pharmacies. Some are adhesive and stick over the bunion, while others are held against your foot by a small loop that fits over your big toe. Bunion pads stop your foot rubbing on your shoe and relieve the pressure over the enlarged joint at the base of your big toe. Orthotics are placed inside your shoes to help realign the bones of your foot. They may help relieve the pressure on your bunion, which can ease the pain. However, there's little evidence that orthotics are effective in the long term. It's important that the orthotic fits properly, so you may want to seek advice from your GP or podiatrist (a specialist in diagnosing and treating foot conditions), who can suggest the best ones for you.
Surgical Treatment
The aim of surgery is to correct the cause of the bunion and prevent it growing back. Which type of surgery your podiatric surgeon recommends will depend on the severity of your bunion. Because there are risks and complications with any type of surgery, it?s not usually advised unless your bunions are causing pain, or if it is starting to deform your other toes.