Bunions

By:    Published: May 7, 2012

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Bunions are a painful condition that affects many women in America. This common deformity of the toes is believed to be largely a result of wearing very narrow shoes that are too tight, as well as shoes with high heels. Although there are other possible causes for bunions, it is probably no coincidence that 9 out of 10 individuals suffering from bunions are women, according to the American Academy of Orthopaedic Surgeons (AAOS).

Definition

When a bunion forms, the joint connecting the big toe to the foot becomes swollen and develops a painful bump. When the big toe is compressed against the other toes, it forces the big toe joint into the opposite direction. When this happens, the joint in the big toe eventually becomes enlarged. The toes continue to be crowded and pain occurs. Eventually, a painful bunion develops overtime.

Similar to a bunion is a bunionette, also known as a tailor’s bunion. These smaller bunions form on the joint at the base of the little toes. It develops in the same way a bunion does, but occurs in a different spot.

Symptoms

There are many painful conditions that can develop on the foot. In addition to bunions, individuals can develop hard corns and bursitis. Symptoms of bunions will develop along the inside edge of the large toe. Bunion symptoms include:

  • A bony, bulging bump
  • Swelling in the joint
  • Redness in the joint
  • Soreness in the joint
  • Pain in the joint that worsens when wearing shoes
  • Big toe facing inward toward the other toes
  • Calluses at the overlap of the first and second toes
  • Limited movement of toe (restricted range of motion)

Pain is one of the most common bunion symptoms, and may occur before a bony bump develops. Bunion pain can be severe enough to prevent you from being able to wear shoes. As the bunion progresses, the pain increases and the bump begins to develop.

Causes

Because bunions are much more common in women, they are believed by many to be a result of wearing high heeled shoes, or shoes that are too narrow or too tight. Not surprisingly, the majority of bunion sufferers are women. Although there may be other causes for the development of bunions, ill-fitting shoes that put stress on the foot are largely to blame. Other possible causes for bunions include:

  • Heredity
  • Abnormal bones structure of the foot from birth
  • Inherited structural defects of the foot
  • Arthritis or other medical conditions

Risk Factors

There are certain risk factors associated with the development of bunions. Because high-heeled shoes that crowd the toes are the number one cause of bunions, avoiding them is recommended. Other risk factors for bunions include:

  • Wearing poor-fitting shoes that are too tight, too narrow or too pointy
  • Having a personal or family history of arthritis
  • Hereditary factors such as inherited foot defects

Diagnostic Tests

Most doctors will be able to accurately diagnose bunions by simply looking at the foot. Your doctor will carefully examine your foot and ask you to wiggle your big toe. He will monitor your range of motion and determine if it is limited. He will check to see if there is any redness or inflammation in the toe. Occasionally, your doctor may order a foot x-ray to check if an abnormal angle exists between the foot and the large toe. An x-ray may also be able to detect if arthritis is present in the foot.

Treatment

It is important to take appropriate measures as soon as a bunion forms. With proper self-care and avoidance or risk factors, you may be able to prevent the condition from worsening without further medical intervention. Simple home-care tips for bunions include:

  • Wearing shoes that have a wide-toe
  • Placing foam pads around the bunion to protect it from further irritation
  • Wearing spacers on the toes to separate them
  • Cutting a toe hole in your house shoes to ease discomfort when you are at home
  • Replacing all poor-fitting shoes with those that provide enough room for the toes to fit comfortably
  • Using over-the-counter foam arch supports
  • Apply an ice pack to reduce swelling

If the bunion pain does not respond to simple home remedies or continue to grow, additional measures may be necessary. Medical treatments will vary according to the severity of the bunion and the amount of pain you are experiencing. More advanced treatment options for bunions include:

  • Non-steroidal anti-inflammatory medications (NSAID’s)
  • Prescription strength pain relievers
  • Cortisone injections
  • Prescription orthotic devices

In extreme cases, when bunions do not respond to any of the above home remedies and treatments, surgery may be required. There are a variety of surgical procedures that can be effective at removing bunions. The type of surgery used will depend largely on the size of the bunion, the amount of pain it is causing and the underlying cause for the development of the bunion.

During surgery, the toe is realigned and the bony bump is removed. The swollen tissue that develops around the big toe joint is also removed. Parts of the bone in the big toe are removed to help straighten out the toe. The long bone that stretches from the back of the foot to the big toe is realigned to straighten out the angle in the large toe joint.

Although bunion surgery has a relatively high success rate, it generally is not recommended unless the condition is severe or interfering with normal every day activities. There are risks involved with the procedure, similar to those that are present for any surgical procedure.

Complications

Bunions are a permanent condition that will not go away without surgery. Smaller bunions that are not painful can often be managed with simple remedies. Larger or more painful bunions may require advanced treatment.

If bursitis occurs, a condition in which the sac of fluid over the joint becomes inflamed, the bunion can become much more severe and can cause intense pain. If bunions continue to grow and become more painful, simple remedies may become less effective and surgery may be required.

Prevention

The best prevention for bunions is to avoid wearing high heeled or poor-fitting shoes. Avoid wearing shoes that squish the toes together or cause too much friction among the toes.

When To Call Your Doctor

Contact your doctor is you have a bunion that does not respond to simple home care treatments. If the bunion continues to cause pain and interferes with your normal daily activities, schedule an appointment with your physician. Contact your doctor immediately if you develop any signs of infection such as swelling, redness or heat. If you are unsure of the cause of your foot condition, make an appointment to have your foot evaluated by your doctor.

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