A bunion is an
enlargement of the joint at the base of the big toe, the metatarsophalangeal (MTP) joint.
A bunion forms when the metatarsal bone moves outward and the big toe moves towards the
second toe. The big toe may bend over or under the second toe. A bunion may cause a
painful lump on the inside area of the foot. Since this joint carries a lot of the
body’s weight while walking, bunions can cause extreme pain if left untreated. The
MTP joint itself may become stiff and painful, causing pain with the wearing of closed
shoes. Bunions– from the Latin "bunio," meaning enlargement–can also
occur on the outside of the foot at the base of the little toe, where it is called a
"bunionette" or "tailor’s bunion."
This condition was named after tailors in Italy, who would sit on the floor
with crossed legs such that their feet rubbed the ground on the outside.
Signs and Symptoms:
- Development of a bone bump on the edge of the foot, at the base of
the big toe, or at the base of the 5th toe.
- Painful overlapping or under riding of the big toe and the second
toe.
- Redness, swelling, pain, calluses or other irritations at or near
the MTP joint.
- Painful limited motion of the big toe.
The Common Causes of a
Bunion:
Bunions form when there is an imbalance of the joints and tendons of the foot. This imbalance can lead to instability of the
joint, thereby causing the deformity. Bunions can form after prolonged abnormal motion and
pressure over the MTP joint. They can also be found in young children and are result of
congenital abnormalities. In general, bunions are the result of faulty foot development,
usually caused by the way we walk, our inherited foot type, our shoes, or other sources.
Although bunions tend to run in families, it is the foot type that is passed down through
the genetic makeup. Parents who suffer from poor foot mechanics can pass their problematic
foot type on to their children, who, in turn, are also prone to developing bunions. The
abnormal functioning caused by this faulty foot development can lead to pressure being
exerted on and within the foot, often resulting in bone and joint deformities such as
bunions and hammertoes.
Other causes of bunions are foot injuries, neuromuscular disorders, arthritic disorders or
congenital deformities. People who suffer from flat feet or low arches are also prone to
developing bunions, as are arthritic patients and those with inflammatory joint disease.
Occupations that place undue stress on the feet can be a factor; ballet dancers, for
instance, often develop the condition.
Wearing shoes that are too tight or that cause the toes to be squeezed together is a
common contributing factor. Though it is
usually not the cause of a bunion, it does explain the high prevalence of the disorder
among women.
Self care at home:
- Apply over the counter, non-medicated bunion pad around the bony
prominence.
- Wear shoes with a wide and deep toe box.
- Avoid high-heeled shoes over two inches tall.
- Call our office if pain persists.
Non-Surgical Treatment
For Bunion Pain:
Treatment options vary with the type and severity of each bunion. Identifying the deformity early in its development
may help in avoiding surgery. Medical attention should be sought at the first indication
of pain or discomfort because, left untreated, bunions tend to get larger and more
painful, making non-surgical treatment less of an option.
The primary goal of most early treatment options is to relieve pressure on the bunion and
prevent the progression of the joint deformity. The following may be recommended:
Anti-inflammatory drugs and
cortisone injections are sometimes used to ease the acute pain and inflammations caused by
joint deformities.
Often used to provide relief of
the inflammation. Ultrasound therapy is a technique for treating associated soft tissue
involvement.
Custom functional orthotics are
used to control foot function and may reduce symptoms and prevent worsening of the
deformity. We use Computerized Analysis to make orthotics.
When early treatments fail or the bunion progresses past
the threshold for such options, surgery may become necessary to relieve pressure and
repair the toe joint.
Corrective surgery:
Several
surgical procedures are available for correction of the bunion. The procedures generally
remove the bony enlargement, restore the normal alignment of the toe joint, and relieve
pain. This correction is achieved by realignment of the bones. We now can use absorbable
screws and special staple for our procedures, which are performed under local monitored
anesthesia on an outpatient basis.
Recuperation takes time, and swelling and some discomfort may be felt for several weeks
following surgery. Pain, however, is easily managed with prescribed medications.
Revised July 1, 2001. |
