Overview
A bunion is a firm, fluid-filled pad overlying the inside of the joint at the base of the big toe (metatarsophalangeal joint). The pad (bursa), which may get larger and stick out, can become inflamed and painful. Bunions may run in families, but many result from wearing tight shoes. Nine out of 10 bunions are developed by women. Nine out of 10 women wear shoes that are too small. Tight shoes also can cause other disabling foot problems like corns, calluses and hammertoes.
Causes
Bunions are most often caused by an faulty foot mechanics. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Although wearing shoes that crowd the toes won't actually cause bunions in the first place, it sometimes makes the deformity get progressively worse. That means you may experience symptoms sooner.
Symptoms
Audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. Inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint. Pain at the side and top of the joint that worsens with walking and physical activity.
Diagnosis
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.
Non Surgical Treatment
Fortunately, many bunions never go on to cause problems other than the cosmetic appearance. The easiest option is to try different shoes or padding, however this is not the answer for everyone. The various straps and braces that are commercially available are not proven to be particularly effective.
Surgical Treatment
When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatrist. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain. A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatrist.
Prevention
If you are genetically at risk, not a lot. But shoes that are too narrow, too tight (even ballet flats) or have very high heels that force your toes down into the pointed end are asking for trouble. Aim for a 1cm gap between your toes and the end of your shoes. This doesn?t mean wearing frumpy flatties, the Society of Podiatrists and Chiropodists recommends sticking to 4cm heels for everyday wear, and wearing different types of shoe to vary the position of your foot. Gladiator styles can help because the straps stop your foot pushing down into the point of the shoe, ditto Mary Janes (sorry but for beautiful feet they need to have a strap), and flat, wide-fitting brogues are a no-brainer. Alternatively, in summer you can wear flip-flops to keep the space between your big and second toe as wide as possible. If you have children it?s vital to make sure that their feet are measured for properly fitting shoes to nip any potential problems in the bud. Keeping your feet and lower legs supple and strong is important too, that?s how A-list celebs get away with wearing killer heels, they all work-out like crazy. Exercises like trying to widen the space between your big toe and the second one with your foot flat on the floor, a few times a day can help, as can calf stretches. If you are devoted to any exercise that involves high impact for your feet, it might be worth checking that your gait and shoes are correct with a specialist shop such as Runners Need, as poor styles can cause irreparable bunion-related problems that will consign your trainers to the back of the cupboard for ever.
A bunion is a firm, fluid-filled pad overlying the inside of the joint at the base of the big toe (metatarsophalangeal joint). The pad (bursa), which may get larger and stick out, can become inflamed and painful. Bunions may run in families, but many result from wearing tight shoes. Nine out of 10 bunions are developed by women. Nine out of 10 women wear shoes that are too small. Tight shoes also can cause other disabling foot problems like corns, calluses and hammertoes.
Causes
Bunions are most often caused by an faulty foot mechanics. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Although wearing shoes that crowd the toes won't actually cause bunions in the first place, it sometimes makes the deformity get progressively worse. That means you may experience symptoms sooner.
Symptoms
Audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. Inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint. Pain at the side and top of the joint that worsens with walking and physical activity.
Diagnosis
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.
Non Surgical Treatment
Fortunately, many bunions never go on to cause problems other than the cosmetic appearance. The easiest option is to try different shoes or padding, however this is not the answer for everyone. The various straps and braces that are commercially available are not proven to be particularly effective.
Surgical Treatment
When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatrist. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain. A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatrist.
Prevention
If you are genetically at risk, not a lot. But shoes that are too narrow, too tight (even ballet flats) or have very high heels that force your toes down into the pointed end are asking for trouble. Aim for a 1cm gap between your toes and the end of your shoes. This doesn?t mean wearing frumpy flatties, the Society of Podiatrists and Chiropodists recommends sticking to 4cm heels for everyday wear, and wearing different types of shoe to vary the position of your foot. Gladiator styles can help because the straps stop your foot pushing down into the point of the shoe, ditto Mary Janes (sorry but for beautiful feet they need to have a strap), and flat, wide-fitting brogues are a no-brainer. Alternatively, in summer you can wear flip-flops to keep the space between your big and second toe as wide as possible. If you have children it?s vital to make sure that their feet are measured for properly fitting shoes to nip any potential problems in the bud. Keeping your feet and lower legs supple and strong is important too, that?s how A-list celebs get away with wearing killer heels, they all work-out like crazy. Exercises like trying to widen the space between your big toe and the second one with your foot flat on the floor, a few times a day can help, as can calf stretches. If you are devoted to any exercise that involves high impact for your feet, it might be worth checking that your gait and shoes are correct with a specialist shop such as Runners Need, as poor styles can cause irreparable bunion-related problems that will consign your trainers to the back of the cupboard for ever.