Definition & Overview

A Bunion is described as a deformity of the big toe. The deformity occurs when a hump develops at the base of the big toe, which in turn causes the toe to push forward and towards the rest of the toes. The condition can be extremely painful, mainly because a bunion is located at a joint of the toe. When walking, a person naturally places his or her weight on that joint, causing an excruciating amount of pain.

The exact causes of bunions are yet to be identified, but many believe that it can be a result of a medical condition or inherited. However, researchers have identified several factors that cause the condition to develop, one of which is undue pressure, which happens when a person wears shoes that are too tight.

Treatment for the condition involves surgical and non-surgical methods, such as choosing the right foot apparel and medications. The key to treating a bunion is to prevent it from getting worse. If a bunion is diagnosed early, the patient is advised on what athletic activities to avoid, what type of shoes to wear, and other methods that can prevent the condition from worsening.

However, it is important that the condition be diagnosed accurately, to include a detailed description of the underlying deformity, its severity, and if another medical condition is present that can either be the cause or is making the condition worse. For example, arthritis is a known factor in the development of bunions.

Cause of Condition

While the exact causes of bunions are still unknown, the abnormality is suspected to be genetic, which means that it is inherited. The inherited instability of the metatarsal phalangeal joint and an imbalance of the muscles result in the deformity.

One of the interesting facts about bunions is that they develop mostly in women. In fact, studies have shown that the condition occurs around ten times more often in women than in men. This would then suggest that shoe wear might play a factor. Tight-fitting and high-heeled shoes do, in fact, increase the risk of a bunion developing. Studies have also shown that bunions are more prevalent among people who wear shoes than those who prefer to go barefoot.

Another possibility or risk factor is arthritic diseases, such as rheumatoid arthritis. This disease is well known to cause bone damage and deformities.

Key Symptoms

Not everybody who has developed bunions experience symptoms. However, those who do report that one of the most noticeable symptoms is pain, which is a direct result of placing pressure on the foot while walking. In most cases, the pain is relieved when the person rests. The pain can be described as being similar to the pain caused by a condition called gout. Gout is almost similar to a bunion because of the enlargement of the toe that it causes. However, with gout, once the swelling subsides, the toe goes back to its normal size. With a bunion, even though the swelling subsides, the toe is already deformed. This is because the enlargement of the toe is due to the enlargement of the bone.

Another noticeable symptom is the enlargement of the joint, which not only deforms the big toe, but also gives an appearance that the entire foot is deformed as well.

Who to See and Types of Treatments Available

Your family doctor is the first person to see if you’ve been experiencing pain in your big toe and noticed a fair amount of swelling that doesn’t seem to subside. Once you’ve described the symptoms, the doctor may begin to suspect that a bunion has formed.

The doctor will then assess the condition of your foot. You will likely need to undergo an x-ray so that the doctor can examine the bone structure of your foot. An x-ray will also help the doctor determine the presence of other underlying conditions such as arthritis.

Once the doctor has determined that the condition is indeed a bunion, you will undergo treatment. While bunions do not necessarily cause other problems, if left untreated, complications such as bursitis, hammertoe, and metatarsaglia can develop. Bursitis is a condition described by the inflammation of the bursae, the small fluid-filled pads near the joints. These pads cushion the bones, tendons, and muscles. Meanwhile, a hammertoe is when the middle joint of the toe becomes deformed. Metatarsaglia, on the other hand, is a condition described as the inflammation of the ball of the foot, which causes a good amount of pain.

Treatment for bunions includes surgical and non-surgical methods. Non-surgical methods include choosing wide shoes that are more comfortable and give ample room for your toes. The doctor may also opt to pad, splint, or tape the foot so that it stays in a normal form. Medications such as NSAIDs and cortisone injections can help to control the pain.

If non-surgical treatment methods fail to improve the condition, the doctor will recommend surgery. The objectives of the surgical procedures are to remove swollen tissue around the joint, joining the affected joints so that they become permanent, realigning and straightening the foot, or straightening the big toe by removing some bone. However, it is important to remember that the doctor will only recommend surgery if the condition has begun to affect your life or if it causes too much pain.

Even after any surgical procedure, you will still need to make simple lifestyle changes to prevent the condition from reoccurring. These changes include making the proper choices in foot apparel and avoiding high-heeled shoes and activities that are known to worsen or trigger the condition.

References:

  • Richardson EG. Disorders of the hallux. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 81.
  • Wexler D, Grosser DM, Kile TA. Bunion and bunionette. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 76.
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