A bunion is a bony growth in the lower joint of your big toe. It usually forms where the big toe pushes over against the second toe, forcing the joint to stick out. As a weight-bearing joint, this can be extremely painful. Calluses and blisters can form on the edge of the bunion, doubling the pain. This crippling foot affliction usually gets worse with time. Surgery for bunions can be complicated, expensive, painful and does not guarantee a well-formed foot as the outcome.
The exact cause of bunions is unknown, but they tend to run in families. Wearing badly fitting shoes is thought to make bunions worse. It’s also thought that bunions are more likely to occur in people with unusually flexible joints, which is why bunions sometimes occur in children. In some cases, certain health conditions, such as rheumatoid arthritis and gout, may also be responsible.
SymptomsSymptoms often include pain, swelling, and abnormal position of the first toe. The technical term for bunions is ?hallux valgus? (HV). This refers to the first toe or hallux moving away or abducting from the middle of the foot and then twisting in such a way that the inside edge actually touches the ground and the outside edge turns upward. This term describes the deviation of the toe toward the outside part of the foot. If left untreated, bunions can worsen over time and cause considerable difficulty in walking, discomfort, and skin problems such as corns. In some cases, a small bursa (fluid-filled sac) near the joint becomes inflamed. This condition is known as bursitis and can cause additional redness, swelling, and pain. Less frequently, bunions occur at the base of the fifth toe. When this occurs, it is called a ?tailor?s bunion? or bunionette.
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI’s are not usually required.
Non Surgical Treatment
When a bunion first begins to develop, take good care of your feet. Wear wide-toed shoes. This can often solve the problem and prevent you from needing more treatment. Wear felt or foam pads on your foot to protect the bunion, or devices called spacers to separate the first and second toes. These are available at drugstores. Try cutting a hole in a pair of old, comfortable shoes to wear around the house.
If these methods fail, then surgery may be suggested. Basically, bunion surgery is performed to improve function or to prevent pain from occurring. When surgery is delayed in a symptomatic foot, greater amounts of arthritis can develop and the more complicated surgery can become. Surgery is performed to improve alignment and function to the big toe joint. The large bump is removed and, sometimes, a cut is made into the bone, to move it to a more normal position. Screws, pins and wires can be used beneath the skin, to improve healing and results. Healing can range from 3-12 weeks, depending on the procedure.