Bunions

Definition

A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. Your big toe joint becomes enlarged, forcing the toe to crowd against your other toes. This puts pressure on your big toe joint, pushing it outward beyond the normal profile of your foot, and resulting in pain. Bunions can also occur on the joint of your little toe (bunionette).

Bunions can occur for a number of reasons, but a common cause is wearing shoes that fit too tightly. They can also develop as a result of inherited structural defect, injury, stress on your foot or another medical condition.

Causes

Bunions form when the normal balance of forces exerted on the joints and tendons of your feet are disrupted. This can lead to instability in the big toe joint — also known as the first metatarsophalangeal (MTP) joint — causing a deformity. Bunions develop over years of abnormal motion and pressure on your big toe joint. They often result from a combination of your inherited foot type, faulty foot mechanics that affect the way you walk and shoes that fit improperly.

Other causes of bunions include:

  • Foot injuries

  • Deformities present at birth (congenital)

  • Neuromuscular disorders, such as cerebral palsy or post- polio syndrome (post-poliomyelitis)

Bunions may be associated with various forms of arthritis, including inflammatory or degenerative, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet also can be a cause. Waiters, factory workers, dancers and athletes often are more prone to developing bunions.

Treatments

Treatment options vary depending on the severity of your bunion and the amount of pain it causes you. Early treatment is best to decrease your risk of developing joint deformities.

Conservative treatment Nonsurgical treatments that may relieve the pain and pressure of a bunion include:

  • Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes.

  • Padding and taping. Your Podiatrist can help you tape and pad your foot in a normal position. This can reduce stress on the bunion and alleviate your pain.(Obviously pending on footwear selection).

  • Medications. Acetaminophen (Tylenol, others) can control the pain of a bunion. Your doctor may suggest nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve), for relieving pain and reducing inflammation. Cortisone injections also can be helpful. But keep in mind that medications do not alleviate the actual cause of the pain.

  • Physical therapy. The heating effect of ultrasound therapy or whirlpool baths can provide relief from the pain and inflammation of a bunion.

  • Orthotics can help control abnormal movement of your foot, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter arch supports can provide relief for some people, though others may require prescription orthotics.

Surgical options

If conservative treatment doesn't provide relief, you may need surgery. A number of surgical procedures are performed for bunions, and no particular surgery is best for every problem. Knowing what caused your bunion is essential for choosing the best procedure to ensure correction without recurrence. Most surgical procedures include:

Removing the swollen tissue from around your big toe joint Straightening your big toe by removing part of the bone Permanently joining the bones of your affected joint You may be able to walk on your foot immediately after some bunion procedures. With other procedures, it may be a few weeks or longer. To prevent a recurrence, you'll need to wear proper shoes after recovery.

Surgery isn't recommended unless a bunion causes you frequent pain. A bunionectomy — like other types of surgery — is not without risk. Additionally, you may still have pain or you could develop a new bunion in your big toe joint after surgery. Consider trying conservative treatment before having a bunionectomy.If you have an underlying mechanical fault,surgery will only correct the aesthetical nature of your bunion for a short period.So therefore surgery is not recommended.

Please consult your Podiatrist.