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Bunions

What is a bunion?

It is an abnormal outgrowth which is bony to the touch and feels like a bump. A bunion forms at the base of your big toe on its joint. A bunion causes your big toe joint to enlarge. This forces your toe to crowd against other toes, and this puts pressure on your big toe joint. This further pushes it outward beyond your foot’s normal profile and eventually results in pain. Bunions can also occur on the little toe joint (bunionette).

Reasons for Bunion Formation

  • Wearing tight shoes
  • Injury
  • Stress on foot
  • Other medical condition

Treatment

  • Changing your shoes
  • Padding your bunion
  • Wearing shoe inserts
  • Severe cases may necessitate surgery for pain relief

Signs and symptoms

  • Bulging outgrowth on the base of the big toe (inside of the toe)
  • Swelling
  • Redness or soreness
  • Skin thickening
  • Overlapping first and second toes result in corns or calluses
  • Persistent pain (mild to severe)
  • Restricted movement of big toe
  • Difficulty walking in normal shoes
  • Effect on other toes due to pressure from your big toe
  • Toenails begin to grow towards the sides of the nail bed
  • Smaller toes may become bent or claw-like (hammertoes)
  • Calluses on the bottom of the foot

Causes

  • The normal balance of joints and tendons gets disrupted
  • This leads to instability of the big toe joint which causes deformity
  • Years of abnormal motion and pressure to the big toe joint
  • Faulty foot development
  • Faulty gait
  • Inherited foot type
  • Improperly fitting shoes (the most common cause of a bunion)
  • Foot injuries
  • Congenital deformities
  • Neuromuscular disorders like post-polio syndrome (post-poliomyelitis) or cerebral palsy
  • Arthritis, which causes deterioration of the protective cartilage covering your big toe joint
  • Your occupation; waitresses, dancers, factory workers, and athletes are more prone to bunions

Treatment

Treatment will depend on the severity of your bunion and the degree of pain you experience. Early treatment is recommended to decrease risk of joint deformities

Conservative Treatment

These are nonsurgical treatments that relieve the pain and pressure of a bunion

Changing shoes

Wear airy and comfortable shoes with plenty of space for the toes

Padding and taping

Padding minimizes pain and allows you to carry on with your normal activities. Seek advice from your doctor with taping and padding your foot in a normal position. This reduces pain and stress on the bunion.

Medication

  • Acetaminophen (Tylenol, others)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
  • Cortisone injections

Physical therapy

Ultrasound therapy or whirlpool baths provide relief from pain and inflammation

Orthotics

Shoe inserts (orthotics) can be very helpful in controlling abnormal movement of the foot. This helps reduce many major symptoms and further prevents a bunion from getting worse. Some people might find relief in over-the-counter arch supports, and others may benefit from prescription orthotics.

Surgical Options

A bunionectomy is effective in many cases and it involves:

  • Removal of the swollen tissue from the area surrounding the big toe joint
  • Straightening of the big toe by removing a part of the bone
  • Permanently rejoining the bones of the affected joint

The patient may be able to walk immediately after some bunion procedures. With other procedures though, it may take a few weeks or longer. Wear proper shoes after recovery to prevent a recurrence of symptoms.

Important note

Surgery is usually recommended only when a bunion causes you significant pain and discomfort. A bunionectomy is after all a kind of surgery and has its own risks:

  • Poor healing
  • Developing an infection
  • Losing some feeling in your foot
  • Continued pain
  • Developing a new bunion

These are some risks involved, therefore it is wise to consider conservative treatment on time.

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