Bunions are a common problem that most people experience as a bony protuberance at the base of the big toe. A bunion, however, is more complicated than simply a bump on the foot. When a patient has a bunion, the big toe angles in toward the other toes, a condition called hallux valgus. Bunions are most common in women, and the cause is most often unsuitable footwear. Causes
Women tend to get bunions more than men. This could be due to the more restrictive footwear they wear, (such as high heels or narrow toe boxes which force the big toe towards the little toes) but women also tend to have looser ligaments, making them slightly more prone. You?re also more likely to get bunions if your parents or grandparents have them.
Symptoms
The symptoms of a bunion include pain, swelling, and redness over the bony bump on the inside of the foot. It can become painful to walk, because the big toe bends every time you take a step. Shoes can become painful to wear, especially ones that are even a little bit tight. Usually, bunions become more painful as they get larger. In severe cases, you can develop arthritis in the big toe as a result of the bunion. However, a bunion that is not painful does not need surgical treatment, even a large one.
Diagnosis
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.
Non Surgical Treatment
Except in severe cases, treatment for bunions is usually given to first relieve the pain and pressure, and then to stop the bunion from growing. Conservative treatment for bunions may include protective padding, typically with felt material, to prevent friction and reduce inflammation. Removing corns and calluses, which contribute to irritation. Precisely fitted footwear that?s designed to accommodate the existing bunion. Orthotic devices to stabilize the joint and correctly position the foot for walking and standing. Exercises to prevent stiffness and encourage joint mobility. Nighttime splints that help align the toes and joint properly. In some cases, conservative treatment might not be able to prevent further damage. This depends on the size of the bunion, the degree of misalignment, and the amount of pain experienced. Bunion surgery, called a bunionectomy, may be recommended in severe cases. This surgery removes the bunion and realigns the toe.
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.