A
bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (
metatarsophalangeal joint).
Bunions form when the toe moves out of place. The enlargement and its
protuberance cause friction and pressure as they rub against footwear.
Over time, the movement of the big toe angles in toward the other toes,
sometimes overlapping a third toe (known as
Hallux Valgus). The
growing enlargement or protuberance then causes more irritation or
inflammation. In some cases, the big toe moves toward the second toe and
rotates or twists, which is known as
Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as
hammertoe.
Many people with bunions suffer from discomfort and pain from the
constant irritation, rubbing, and friction of the enlargement against
shoes. The skin over the toe becomes red and tender. Because this joint
flexes with every step, the bigger the bunion gets, the more it hurts to
walk. Over time, bursitis or
arthritis may set in, the skin on
the bottom of the foot may become thicker, and everyday walking may
become difficult—all contributing to chronic pain.
Wearing shoes that are too tight is the leading cause of bunions.
Bunions are not hereditary, but they do tend to run in families, usually
because of a faulty foot structure. Foot injuries, neuromuscular
problems,
flat feet, and
pronated feet can contribute
to their formation. It is estimated that bunions occur in 33 percent of
the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by
themselves. The goal for bunion treatment is twofold: first, to relieve
the pressure and pain caused by irritations, and second to stop any
progressive growth of the enlargement. Commonly used methods for
reducing pressure and pain caused by bunions include:
-
Protective padding, often made from felt material, to eliminate the
friction against shoes and help alleviate inflammation and skin
problems.
-
Removal of corns and calluses on the foot.
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Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
-
Orthotic devices—both over-the-counter and
custom made—to help stabilize the joint and place the foot in the
correct position for walking and standing.
-
Exercises to maintain joint mobility and prevent stiffness or arthritis.
-
Splints for nighttime wear to help the toes and joint align properly.
This is often recommended for adolescents with bunions, because their
bone development may still be adaptable.
Surgical Treatment
Depending on the size of the enlargement, misalignment of the toe, and
pain experienced, conservative treatments may not be adequate to prevent
progressive damage from bunions. In these cases, bunion surgery, known
as a
bunionectomy, may be advised to remove the bunion and realign the toe.