A bunion develops if the joint where the big toe attaches to the rest of the foot becomes enlarged. This joint is called the metatarsophalangeal (MTP) joint.
When the bones shift outward a bony bump develops and the big toe angles towards the second toe.
At first, you may not even notice a slight bump, but as the condition becomes more severe, redness, swelling and pain may develop in the joint and overlying skin and the bump becomes larger.
What causes bunions?
Bunions occur due to imbalances in the way the joints and tendons are forced to work, due to years of abnormal motion in the foot. This causes pressure against the metatarsophalangeal joint and the bunion, and other foot problems develop.
Bunions can also run in families but really, it is that the type of foot that is susceptible to bunion development is passed down to children.
Other times bunions occur after an injury, or from other conditions such as arthritis and in those who have flat feet or low arches, as their feet roll inward as they walk.
Another common factor in bunion formation is wearing shoes that squeeze the toes too close together, such as high heels. This is why bunions occur more often in women then men.
What can help?
• Wear only shoes with a large or roomy toe box to prevent continued pressure on the bunion.
• Place a bunion pad, which looks like a donut-shaped felt pad, that cushions the bump by making the skin surrounding the bump thicker, so it is less susceptible to pressure
• Use ice several times a day to reduce swelling.
• Avoid high heels entirely. Do not wear any shoe with a heel higher than two inches.
If these first-line measures do not help, then this is a good time to consult a podiatrist. He may suggest the following:
• Orthotics or arch supports:
Orthotics are shoe inserts that help balance the motion of the foot. These can be purchased over the counter. But do not purchase the ones from your local drugstore, they do not offer enough support.
Check with a specialty store such as REI or a special running shoe store. A specialty shoe store will also have knowledgeable people who can help you select better fitting shoes.
Or go to this link, which is run by a podiatrist who is reputable: http://www.footankle.com/off-the-shelf.htm
Your podiatrist may suggest casting your feet for orthotics but it is worth trying one of these less expensive inserts first.
• Taping or bracing with a splint: There are methods to tape the large toe, as well as devices that help put the great toe in better alignment that may reduce pain. Sometimes a gel toes separator may help.
• Medications: Your podiatrist may suggest you take oral anti-inflammatories to reduce swelling or suggest a cortisone injection if the pain is progressing.
• Physical therapy: According to APMA, ultrasound treatment may reduce soft tissue redness and inflammation symptoms. A PT will also give you exercises to strengthen your feet.
The last resort:
If none of the above measures help, then your podiatrist may suggest bunion surgery called a bunionectomy to realign the joint. Recuperation from bunion surgery takes many weeks, and pain medication will be prescribed.
Do your research to find an experienced podiatric surgeon you feel comfortable with. Ask for the names of patients who he has done bunion surgery on who are satisfied with the results.
To look for podiatrists in your area, go to the APMA at http://www.apma.org/default.aspx/
Bunions. American Podiatric Medical Association. Retrieved Mar. 25, 2012.
Bunions and Great Toe Arthritis/Hallux Limitus. Foot and Ankle Center of Washinton. Retrieved Mar. 25, 2012.
Home Treatment for Bunions, Big Toe Joint Pain and Big Toe Callus. Foot and Ankle Center of Washinton. Retrieved Mar. 25, 2012.
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith