Bunions

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Disorders-Bunions.jpgA bunion is caused when the great toe points toward the second toe. As the condition progresses, the great toe presents a large bony bump on the outside.

The enlargement makes the big toe joint stick out further on the side, and forces the big toe to curve in closer to the other toes. For some people, bunions cause little or no pain.

CAUSES

Bunions, and the resulting pain, are a widespread ailment that can be caused by many different factors. Shoes, genetics, weight, job, activity level, and the type of foot you have (flat, high arch, ext.) are all factors that can contribute to the formation of painful foot bunions.  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 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)

DIAGNOSIS

Visual inspection and physical examination are the primary means of diagnosis. Once the toe begins to turn in and lean against the other toes, the condition is obvious.

SYMPTOMS

At first, bunions may cause no pain and may feel as though they are just a cosmetic annoyance. Over time, as the big toe begins to turn in towards the other toes, people with bunions usually experience redness, pain, swelling, and tenderness in the area around the joint. Pressure inside the joint or from footwear pressing against the bunion may also cause discomfort. As the affected toe curves closer to the other toes on the foot, these toes can become painful as well. Corns, calluses and burning sensations are all common.

TREATMENT

Selecting appropriate footwear so that the problem does not get worse over time is the foremost. Well fitting shoes that can accommodate cushions and pads offer the most comfort. It may be necessary to take an over the counter pain reliever from time to time. People with more severe bunions may need more specific treatment, such as surgery.

Surgery involves shaving the inflamed tissue around the big toe joint. A part of the bone in the great toe is cut to straighten the toe (osteotomy). The ligaments are tightened and adjusted in a proper direction. Screws and pins are often used to fuse the bones together. After surgery, you will be instructed on your care, which will include wearing a boot, corrective shoe and possible the use of crutches temporarily.