Bunions

 

A bunion is a bump or bony enlargement of the joint at the base of the big toe.  This bump forms when the big toe and the bone connecting to the big toe move out of place.  Generally the big toe bends toward the smaller toes, and a bony bump forms on the inside of the foot at the base of the big toe.  Bunions can become painful due to the significant amount of body weight that is transferred through that area while walking.  The bony bump can rub on shoes, causing irritation and pain.  The big toe joint may become stiff and sore due to the mal alignment of the joint.

 

Symptoms

 

Bending of the big toe toward with little toes with a bony bump on the inside edge of the foot just below the big toe.  Redness, pain or swelling at the base of the big toe.  Calluses or other irritation to the bony bump.  The 2nd toe may overlap the big toe.  Pain and stiffness of the big toe joint.

 

Causes

 

Bunions are a deformity caused by improper mechanics while walking.  Feet have large amount of force and pressure place on them while walking, and improper walking mechanics can cause deformity over time.  This occurs slowly, over time where abnormal motion and pressure cause tendon and joint imbalances that change the position of bones in the foot.

 

Other causes of bunions include trauma, congenital deformity, flat feet, wearing improper shoe size, neuromuscular disorders, and regularly placing high stress on the feet (ie. dancers).

 

Treatment

 

Treatment usually consists of accommodating the deformity.  This can be done by buying wider shoes, padding the bony bump, avoiding high heeled shoes, orthotics, and taking anti-inflammatory medication.

 

Surgical treatment for bunions is typically reserved for painful bunions that are not relieved by conservative care.  There are many different procedures to correct a bunion deformity.  Generally surgical procedures for bunions include removing the bony bump, realigning the joint, and straightening out the big toe.  Recovery varies depending on the procedure.  Immediate post operative pain is usually managed with rest, elevation of the foot, and medication.  Discomfort and swelling are common for several weeks following surgery.