Overview
Bunions are more common in women than men. The problem can run in families. People born with abnormal bones in their feet are more likely to form a bunion. Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion. The condition may become painful as the bump gets worse. Extra bone and a fluid-filled sac grow at the base of the big toe. Because a bunion occurs at a joint, where the toe bends during normal walking, your entire body weight rests on the bunion at each step. Bunions can be extremely painful. They are also vulnerable to excess pressure and friction from shoes and can lead to the development of calluses.
Causes
In most cases, bunions are caused by genetics and incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, arthritis or an injury produces a bunion. In other cases people are simply born with extra bone near a toe joint. Tight fitting shoes further complicate the condition. Shoes such as high heels are particularly damaging to the toes. These shoes have a sloping foot piece and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box. The narrow toe box causes the toes to become squeezed together. Depending on factors such as duration of wearing constraining footwear, skeletal maturity, and individual factors, the toes can be- come permanently adapted to the new position and lead to the formation of a bunion. Once a bunion forms, the mechanics of the feet and toes are altered. Tendons begin to pull the toe into an abnormal position, and the problem tends to progress over time.
Symptoms
Bunions or hallux valgus tend to give pain predominantly from the metatarsal head on the inner border of the foot. The bunion tends to be painful mainly when in enclosed shoes and so is often more symptomatic in winter. As the front part of the foot splays and the great toe moves across towards the 2nd toe a bunion can also produce pain from the 2nd toe itself. The pain which a bunion produces on the 2nd toe is either due to direct rubbing between the great toe and the 2nd toe, a hammer toe type deformity produced due to crowding of the 2nd toe by the bunion and the 3rd toe.The hammer toe will either be painful from its top aspect where it rubs directly on shoe wear or its under surface in the area of the 2nd metatarsal head. This is made prominent and pushed to the sole of the foot by the 2nd toe rising upwards and driving the metatarsal head downwards.
Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).
Non Surgical Treatment
Before treatment of a painful bunion can begin, medical evaluation is needed. There are a number of other causes of pain in the big toe such as osteoarthritis, rheumatoid arthritis, infection and gout. Circulatory problems not only cause pain, but may also cause serious complications if surgery is attempted. Diabetes and cigarette smoking may diminish healing potential and increase the risk of infection.
Surgical Treatment
There are a number of different surgical procedures used to treat bunions. The type of surgery recommended for you will depend on the severity of the deformity. Your surgeon may use pins, wires or screws to hold the bones in place while they heal. Depending on the type of surgery you have, these may be left in your foot or removed later on. Some of the surgical procedures for bunions are described below. Osteotomy is the most commonly used and proven type of bunion surgery. Although there are many different types of osteotomy, they generally involve cutting and removing part of the bone in your toe. During the procedure, your surgeon will remove the bony lump and realign the bones inside your big toe. They'll also move your toe joint back in line, which may involve removing other pieces of bone, possibly from the neighbouring toes. A procedure called distal soft tissue realignment may be combined with an osteotomy. This involves altering the tissue in your foot to help correct the deformity and improve the stability and appearance of the foot.
Bunions are more common in women than men. The problem can run in families. People born with abnormal bones in their feet are more likely to form a bunion. Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion. The condition may become painful as the bump gets worse. Extra bone and a fluid-filled sac grow at the base of the big toe. Because a bunion occurs at a joint, where the toe bends during normal walking, your entire body weight rests on the bunion at each step. Bunions can be extremely painful. They are also vulnerable to excess pressure and friction from shoes and can lead to the development of calluses.
Causes
In most cases, bunions are caused by genetics and incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, arthritis or an injury produces a bunion. In other cases people are simply born with extra bone near a toe joint. Tight fitting shoes further complicate the condition. Shoes such as high heels are particularly damaging to the toes. These shoes have a sloping foot piece and a narrow toe box. The slope causes the front of the foot to be pushed with force into the narrow toe box. The narrow toe box causes the toes to become squeezed together. Depending on factors such as duration of wearing constraining footwear, skeletal maturity, and individual factors, the toes can be- come permanently adapted to the new position and lead to the formation of a bunion. Once a bunion forms, the mechanics of the feet and toes are altered. Tendons begin to pull the toe into an abnormal position, and the problem tends to progress over time.
Symptoms
Bunions or hallux valgus tend to give pain predominantly from the metatarsal head on the inner border of the foot. The bunion tends to be painful mainly when in enclosed shoes and so is often more symptomatic in winter. As the front part of the foot splays and the great toe moves across towards the 2nd toe a bunion can also produce pain from the 2nd toe itself. The pain which a bunion produces on the 2nd toe is either due to direct rubbing between the great toe and the 2nd toe, a hammer toe type deformity produced due to crowding of the 2nd toe by the bunion and the 3rd toe.The hammer toe will either be painful from its top aspect where it rubs directly on shoe wear or its under surface in the area of the 2nd metatarsal head. This is made prominent and pushed to the sole of the foot by the 2nd toe rising upwards and driving the metatarsal head downwards.
Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).
Non Surgical Treatment
Before treatment of a painful bunion can begin, medical evaluation is needed. There are a number of other causes of pain in the big toe such as osteoarthritis, rheumatoid arthritis, infection and gout. Circulatory problems not only cause pain, but may also cause serious complications if surgery is attempted. Diabetes and cigarette smoking may diminish healing potential and increase the risk of infection.
Surgical Treatment
There are a number of different surgical procedures used to treat bunions. The type of surgery recommended for you will depend on the severity of the deformity. Your surgeon may use pins, wires or screws to hold the bones in place while they heal. Depending on the type of surgery you have, these may be left in your foot or removed later on. Some of the surgical procedures for bunions are described below. Osteotomy is the most commonly used and proven type of bunion surgery. Although there are many different types of osteotomy, they generally involve cutting and removing part of the bone in your toe. During the procedure, your surgeon will remove the bony lump and realign the bones inside your big toe. They'll also move your toe joint back in line, which may involve removing other pieces of bone, possibly from the neighbouring toes. A procedure called distal soft tissue realignment may be combined with an osteotomy. This involves altering the tissue in your foot to help correct the deformity and improve the stability and appearance of the foot.