Bunions are bony protrusions located at the base of the big toe that develop when the toe is slanted inward or overlaps the next toe. They can be very painful. Bunions form when the movement of the big toe influences the angle of the bones in the foot. The changes gradually develop into the characteristic bump, which over time becomes more and more noticeable.
Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. While the precise causes are not known, there also seems to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals. Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital), nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.
SymptomsBunions are an often painful condition that may become even more painful as extra bone and a fluid-filled sac grow at the base of your big toe. Some of the most frequently experienced signs and symptoms associated with bunions, besides pain, include redness in your affected area. Blistering over your bunion. Callus formation around your bunion. Bursitis. Nerve damage (numbness and/or sharp pains) in your involved area. Bunions may also cause pain within and below your first metatarsophalangeal, or MTP, joint. Your bunion may become further dislocated and unstable as it progresses and may overload your adjacent joints.
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI’s are not usually required.
Non Surgical Treatment
Long-term treatment of bunions must be directed towards re-balancing the foot, so that we no longer walk with our weight forced on to the inner border of the foot. This is accomplished by controlling and reducing pronation with the use of a high quality arch support or custom made orthotics. These devices comfortably re-balance the feet and overcome pronation. This reduces the abnormal weight forces on the big toe and its metatarsal head, allowing the feet to function normally. As a result, the deformity should not worsen, and the pain should gradually subside. If the foot is not re-balanced, the deformity and pain will become worse.
Anyone who experiences symptoms from bunions should see a podiatrist for treatment. But you may benefit from surgery if you have any of the following. Severe foot pain that limits your everyday activities, including walking and wearing comfortable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. Chronic big toe inflammation and swelling that doesn?t improve with rest or medications. Toe deformity, a drifting of your big toe toward the small toes. Toe stiffness, inability to bend and straighten your toes. Failure to obtain pain relief from anti-inflammatory drugs. Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medications.