Overview
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.
Causes
The main cause of bunions is a mechanical imbalance in the feet which is usually inherited. The mechanical imbalance is known as overpronation, where the feet roll in towards the arch and big toe. This added weight and stress transfer towards the big toe, causes instability in the structures of this area and a bunion develops.
Symptoms
Audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. Inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint. Pain at the side and top of the joint that worsens with walking and physical activity.
Diagnosis
A doctor can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.
Non Surgical Treatment
Several things can be done to help relive the pain of bunions. These won't make the bunion go away, but they can make the foot more comfortable. Wearing different shoes. Shoes with a wide toe box rather than a pointed one will help. Shoes with lower heels will also help. (High heels throw more of the body's weight on the front part of the foot where the toe joints are.) Padding. Pads placed over the bunion may help reduce the pain. These are available from a drug store or may be available from a foot and ankle surgeon. Avoiding activities that make the pain worse. This includes standing for a long time or other activities that make the bunion sore. Non-steroidal anti-inflammatory drugs. These include aspirin or ibuprofen. They relieve pain and swelling. Applying an ice pack to reduce swelling and pain. Corticosteroid injections. These are not often used in bunion treatment. Injecting corticosteroids sometimes helps if the bursa is inflamed. (Bursa is a fluid-filled sac within a joint to cushion the bones). Orthotic devices. These are devices placed inside a shoe that shift the positioning of the foot. Orthotics help compensate for structural issues that cause foot problems.
Surgical Treatment
For those whose bunions cause persisting pain, a surgical operation is considered for correction of the bunion. The surgical operation to correct a bunion is referred to as a bunionectomy. Surgical procedures can correct deformity and relieve pain, leading to improved foot function. These procedures typically involve removing bony growth of the bunion while realigning the big toe joint. Surgery is often, but not always, successful; failure to relieve pain can result from the big toe moving back to its previous deviated position even after surgery. However, proper footwear and orthotics can reduce the chances of surgical failure.
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.
Causes
The main cause of bunions is a mechanical imbalance in the feet which is usually inherited. The mechanical imbalance is known as overpronation, where the feet roll in towards the arch and big toe. This added weight and stress transfer towards the big toe, causes instability in the structures of this area and a bunion develops.
Symptoms
Audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. Inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint. Pain at the side and top of the joint that worsens with walking and physical activity.
Diagnosis
A doctor can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.
Non Surgical Treatment
Several things can be done to help relive the pain of bunions. These won't make the bunion go away, but they can make the foot more comfortable. Wearing different shoes. Shoes with a wide toe box rather than a pointed one will help. Shoes with lower heels will also help. (High heels throw more of the body's weight on the front part of the foot where the toe joints are.) Padding. Pads placed over the bunion may help reduce the pain. These are available from a drug store or may be available from a foot and ankle surgeon. Avoiding activities that make the pain worse. This includes standing for a long time or other activities that make the bunion sore. Non-steroidal anti-inflammatory drugs. These include aspirin or ibuprofen. They relieve pain and swelling. Applying an ice pack to reduce swelling and pain. Corticosteroid injections. These are not often used in bunion treatment. Injecting corticosteroids sometimes helps if the bursa is inflamed. (Bursa is a fluid-filled sac within a joint to cushion the bones). Orthotic devices. These are devices placed inside a shoe that shift the positioning of the foot. Orthotics help compensate for structural issues that cause foot problems.
Surgical Treatment
For those whose bunions cause persisting pain, a surgical operation is considered for correction of the bunion. The surgical operation to correct a bunion is referred to as a bunionectomy. Surgical procedures can correct deformity and relieve pain, leading to improved foot function. These procedures typically involve removing bony growth of the bunion while realigning the big toe joint. Surgery is often, but not always, successful; failure to relieve pain can result from the big toe moving back to its previous deviated position even after surgery. However, proper footwear and orthotics can reduce the chances of surgical failure.