A bunion is a firm, painful bump that forms over a bony bulge at the base of the big toe. In most cases, the big toe joint also is enlarged and has degenerative arthritis. The toe also may be pushed toward the second toe (hallux valgus). Bunions tend to be inherited, but they also are common in the following groups. Women who wear high heels. People who wear shoes that are too narrow or too pointed. People with flatfeet. All of these situations force the big toe to drift toward the little toes, and this can cause bunions to form.
Causes of bunions and risk factors for bunions include a family tendency to bunions may make them more likely to develop. Arthritis of the foot, if it affects walking, it can make bunions more likely to develop. Neuromuscular problems, such as cerebral palsy. Biomechanical factors, such as low arches, flat feet and hypermobile joints, can increase the risk. Wearing shoes that are too tight, too narrow and with pointed toes will exacerbate symptoms if bunions are present. Wearing high heels will also exacerbate existing bunions. Women are more prone to bunions than men.
Patients with bunions will often display pain over the prominent bump on the inside of their forefoot (the medial eminence?). However, they may also have pain under the ball of the foot (under the area near the base of the second toe). Symptoms can vary in severity from none at all to severe discomfort aggravated by standing and walking. There is no direct correlation between the size of the bunion and the patient?s symptoms. Some patients with severe bunion deformities have minimal symptoms, while patients with mild bunion deformities may have significant symptoms. Symptoms are often exacerbated by restrictive shoe wear, particularly shoes with a narrow toe box or an uncomfortable, stiff, restraining upper.
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
Your doctor may recommend a prescription or over-the-counter pain reliever, as well as medication to relieve the swelling and inflammation. A heat pad or warm foot bath may also help relieve the immediate pain and discomfort. A few people may obtain relief with ice packs. If your bunion isn't persistently painful and you take action early on, changing to well-made, well-fitting shoes may be all the treatment you need. Your doctor may advise use of orthoses (devices that are used to improve and realign the bones of your foot), including bunion pads, splints, or other shoe inserts, provided they don't exert pressure elsewhere on the foot and aggravate other foot problems. In some cases, an orthotist (someone trained to provide splints, braces and special footwear to aid movement, correct deformity and relieve discomfort) can recommend shoes with specially designed insoles and uppers that take the pressure off affected joints and help the foot regain its proper shape.
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it?s time to discuss surgical options with a foot and ankle surgeon. Together you can decide if surgery is best for you. A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the ?bump? of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
If these exercises cause pain, don't overdo them. Go as far as you can without causing pain that persists. This first exercise should not cause pain, but is great for stimulating blood and lymphatic circulation. Do it as often as you can every day. Only do this exercise after confirming it is OK with your doctor. Lie on your back and lift up your legs above you. Wiggle your toes and feet. Eventually you may be able to rapidly shake your feet for a minute at a time. Use your fingers to pull your big toe into proper alignment. Stretch your big toe and the rest of your toes. Curl them under for 10 seconds, then relax and let them point straight ahead for 10 seconds. Repeat several times. Do this at least once a day, and preferably several times. Flex your toes by pressing them against the floor or a wall until they are bent back. Hold them for 10 seconds, then release. Repeat several times. Grip with your toes. Practice picking up an article of clothing with your toes, dropping it, and then picking it up again. Warm water. Soak your feet for 20 minutes in a bowl of warm water. Try doing the foot exercises while soaking, and also relax and rest your feet. Epsom salts. Add it to your warm foot bath soak.