A Bunion is one of the most common foot ailments which usually occur near the joint at the base of the big toe. It is actually a bony protrusion which consists of excess or misaligned bone in the joint. Although they may develop on the fifth or little toe, bunions usually occur at the base of the big toe. In addition to causing pain, a bunion changes the shape of your foot, making it harder to find shoes that fit. The good news however, is that you don?t have to hobble for the rest of your life, bunions can be treated.
By far the most common cause of bunions is the prolonged wearing of poorly fitting shoes, usually shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position. Bunions also may be caused by arthritis or polio. Heredity often plays a role in bunion formation. But these causes account for only a small percentage of bunions. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.
Often the bunion is not painful and the individual leads a normal active life. Other times the bunion can be very painful, even debilitating. Pain is usually very achy and typically radiates to the toes and along the arch of the foot. Due to the abnormal positioning of the bones in the foot, sharp nerve pains could also be present.
People with bunions may be concerned about the changing appearance of their feet, but it is usually the pain caused by the condition that leads them to consult their doctor. The doctor will evaluate any symptoms experienced and examine the affected foot for joint enlargement, tissue swelling and/or tenderness. They will also assess any risk factors for the condition and will ask about family history. An x-ray of the foot is usually recommended so that the alignment of big toe joint can be assessed. This would also allow any other conditions that may be affecting the joint, such as arthritis, to be seen.
Non Surgical Treatment
Separating the big toe and the next one with a 1 cm thick piece of foam can relieve painful symptoms. This can be fixed in place with some zinc oxide plaster tape and has the effect of straightening the great toe and relieving pressure on the bunion. A taping technique will support the joint and relieve the pressure on the inside of the foot. Off the shelf orthotic insoles can be worn to help correct any biomechanical problems in the foot which may be causing the problem. If the foot rolls in or over pronates then this causes the arch of the foot to flatten and more pressure is placed on the base of the big toe where the bunion forms. A podiatrist is a therapist who specializes in feet. They can do a full gait analysis and make orthotic inserts to correct biomechanical foot problems. Severe cases may require surgery to realign the joint but this is a last resort if conservative treatment has failed.
There are many different procedures described to correct bunions. You should be aware that usually just shaving the bunion off, although it is attractive and minimally invasive, is usually not enough. Initially the foot will look much better but with time the bunion will recur. Arthrodesis refers to surgery performed on the great toe joint where the joint is fused. This is usually reserved for people with very severe deformities when other surgical options are impossible. Bunionectomy refers to the simple removal of the bunion itself. This is seldom used because it doesn?t correct the underlying bone problems. Osteomety is the commonest surgical procedure. The bone is cut and the bones realigned and pinned in place until they heal so that the underlying bone deformity is corrected and the bunion will not recur. The resection arstplasty refers to the removal of the toe joint and this creates a flexible scar that functions as the joint instead. In the past there has been some interest in implanting artificial joints but this has fallen out of favor due to the fact that they usually do not hold up with the normal every day stress that people put their feet through.