Bunions (sometimes referred to as Hallux abducto valgus) are enlargements of the inner portion of the metatarsophalangeal (MTP) joint at the base of your big toe. More commonly, they are described as a bump on the side of the big toe. The foot bunion is the result of changes that occur in the framework of the bones at the front of your foot. Instead of pointing straight ahead, your big toe begins to lean into your second toe, throwing the bones out of alignment. Bunions are progressive, meaning you will not just wake up one day and find a visible bump (unless it was caused by a bug bite or something of that nature). Bunions are generally attributed to genetics and improper footwear. It may take years for a bunion to fully develop and begin to show symptoms. Some people may never experience symptoms at all. Bunions may begin to form during one?s teenage years, but they usually occur in people aged 20-30. Women are three times more likely than men to have bunions.
Bunions occur with greater regularity in women than men, and they may sometimes run in families. You may also have an increased likelihood of bunions if you are born with certain bone abnormalities in your feet. Factors that may increase your chances of developing a bunion include long-term use of narrow-toed and/or high-heeled footwear. Arthritis. Toe trauma. Laxity of your connective tissues (ligament laxity). Limb length inequalities. Genetics. Certain foot problems (e.g. flatfoot, over-pronation, etc.).
Symptoms of a bunion include irritated skin, sensitivity to touch, and pain when walking or running. Since the bunion may grow so prominent as to affect the shape of the foot, shoes may no longer fit properly, and blisters may form at the site of friction and pressure. Bunions may grow so large that an individual must wear shoes that are a larger size than they would otherwise wear. If the bunion becomes a severe case, walking may become difficult.
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.
Non Surgical Treatment
Treatment may be surgical or non-surgical. The goal of non-surgical treatment is to relieve pressure on the foot and to prevent pressure sores and foot ulcers. This is accomplished by prescribing accommodative shoes with a wide toe box - sandals or extra depth shoes with soft moulded insoles. It may also be possible to relax the leather on shoes to make room for a bunion.
There is more than one way to surgically treat a bunion. While there are some general guidelines, some procedures work well for some Surgeons and poorly for others. Your Surgeon should consider the severity of your bunion, medical condition, lifestyle, and recuperation time when considering the surgical treatment.