Bunions are probably the most common deformity seen in the adult foot. The term ?bunion? is actually Latin for turnip. The scientific phrase used to describe a bunion is hallux valgus. Hallux is Latin for great toe, while valgus means deviation towards the outer side of the body. Bunions come in all shapes and sizes. This causes significant variation in symptoms and also in the extent of the surgery required to correct a bunion. Most patients who have symptomatic bunions complain of pain on the medial, or inner aspect of the big toe. However, bunions may also cause pain underneath the big toe, or even under the second toe.
Women tend to get bunions more than men. This could be due to the more restrictive footwear they wear, (such as high heels or narrow toe boxes which force the big toe towards the little toes) but women also tend to have looser ligaments, making them slightly more prone. You?re also more likely to get bunions if your parents or grandparents have them.
Bunions may or may not cause symptoms. A frequent symptom is foot pain in the involved area when walking or wearing shoes that is relieved by resting. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. This leads to intermittent or chronic pain at the base of the big toe. Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness. It is important to note that, in post-pubertal men and post-menopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that is similar to the pain caused by bunions.
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.
Non Surgical Treatment
Bunions may be treated conservatively with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by an orthopedic surgeon or a podiatric surgeon, may be necessary if discomfort is severe enough or when correction of the deformity is desired. Orthotics are splints or regulators while conservative measures include various footwear like gelled toe spacers, bunion toes separators, bunion regulators, bunion splints and bunion cushions. There are a variety of available orthotics (or orthoses) including over-the-counter or off-the-shelf commercial products and as necessary, custom-molded orthotics that are generally prescribed medical devices.
Bunion surgery involves realigning the joint into a better position. The procedure is usually performed under a general anaesthetic so the patient is not awake during the operation. A bunion causes a prominent bone over the inside of the joint between the foot and the big toe known as the 1st metatarso-phalangeal joint. It gives the appearance of the big toe pointing in towards the others. Surgery is a last resort treatment option in severe cases where walking or wearing shoes is painful.
Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family. Exercising your feet can strengthen them. Learn to pick up small objects, like a pencil or pebble, with your toes. Wear shoes that fit properly and don’t cramp or pinch your toes. Women should avoid shoes with very high heels or pointed toes.
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