When the big toe is misaligned, it creates an unnatural bump on the inside of the forefoot (see image below). In addition to being unsightly, the lump or bunion can cause pain and make buying shoes difficult. Some people are born predisposed to bunions. But most people acquire them over time from ill-fitting footwear that squeezes the big toe inward toward the other toes. About four out of five bunion pain patients are female, a near perfect fit for the bad shoe theory. The good news, Bunions can be corrected, often with better-fitting shoes and custom orthotics. There are also some cases that cause severe bunion pain and do not respond to conservative treatment. For those patients, bunion surgery called bunionectomy may be necessary.
The most common cause of bunions is poor footwear. Poorly fitted shoes, high heeled shoes or shoes with a narrow toe area can all cause bunions or make bunions worse. Bunions can be hereditary and they can be associated with poor foot biomechanics such as overpronation or flat feet. Rheumatoid arthritis or some diseases of the nervous system can also cause bunions.
A bony bump along the edge of the foot, at the base of the big toe (adjacent to the ball of the foot) Redness and some swelling at or near the big toe joint. Deep dull pain in the big toe joint. Dull achy pain in the big toe joint after walking or a sharp pain while walking. The big toe is overlapping the second toe, resulting in redness, calluses, or other irritations such as corns.
Looking at the problem area on the foot is the best way to discover a bunion. If it has the shape characteristic of a bunion, this is the first hint of a problem. The doctor may also look at the shape of your leg, ankle, and foot while you are standing, and check the range of motion of your toe and joints by asking you to move your toes in different directions A closer examination with weight-bearing X-rays helps your doctor examine the actual bone structure at the joint and see how severe the problem is. A doctor may ask about the types of shoes you wear, sports or activities (e.g., ballet) you participate in, and whether or not you have had a recent injury. This information will help determine your treatment.
Non Surgical Treatment
Bunions often respond to conservative care measures and should always be treated by a qualified healthcare professional in a timely and appropriate manner. Conservative treatment for bunions usually involves the following, splinting your great toe (so that it does not migrate toward the inside edge of your foot). A toe-spacer (such as Correct Toes) may be a useful tool, because it helps progressively splay and re-align all of your toes. Performing range of motion exercises (to move your big toe into a more favorable position). Supporting of the joints in the back of your foot that cause forefoot instability. Using shoes that allow the bunion splint to keep your big toe pointing straight ahead.
The main goal of surgery is to realign the big toe joint in order to relieve symptoms, correct deformity and restore function. Surgery to remove a bunion is known as a bunionectomy. There are many variations of this operation and the type of surgery performed will vary depending on factors such as the degree of deformity, the strength of the bones, the person's age and the surgeon?s preferred approach. Most surgery involves the removal of the bony outgrowth (exostosis) and the realignment of the bones of the joint. Soft tissue structures such as the ligaments and tendons may be repositioned and the bursa may be removed. The insertion of screws and pins may be required to stabilise the bones in their new, realigned position.
Make better shoe choices. If you?re a woman, avoid high-heeled footwear whenever possible (at the very least, choose shoes with heels lower than two inches), and make sure all your footwear has a wide, deep toe box. Whether man or woman, if you?re trying on shoes and your toes feel ?squished? or crowded by a particular shoe, reject that style and try another, or go for a larger size. You don?t need to invite trouble. In general, shoes that come to a point at the toe are bad news, as they tend to push the toes together into an overlapping pattern. Shoes with rocker soles will unload pressure on the bunion area. Examine your feet regularly. Note any redness, swelling or discoloration. Flex your toes and check for any stiffness. If there is any, think back to what you?ve worn or done in the past few days. If the condition persists more than a few days, or worsens, a visit to the podiatric physician is in order.