A simple bunion is an abnormal bump of bone that is formed at the head of our old friend, the first metatarsal bone. The bunion can either be on the top or side of the first metatarsal bone. In a more advanced bunion deformity, called Hallux Abducto Valgus, there starts to be a movement of the big toe toward the second toe. The most severe bunion is when the first toe not only moves toward the second toe, but it overlaps or underlaps the second toe. Bunions can cause swelling of the feet to occur.
Various factors, including a tight gastrocnemius (or calf) muscle and instability of the arch, contribute to formation of bunions. The tight calf muscle is often hereditary and can cause a bunion because it forces more loading, or pressure, on the forefoot. Ultimately, this can contribute to instability in the bones, ligaments and tendons that form the arch. When it?s unstable, the arch starts collapsing and the metatarsal can shift. Arch instability can also be brought on by obesity, again, due to chronic overloading of the foot. But, by far, the most common contributing factor is childbirth. Bunions are most common in women who have had children. This happens because the hormones that affect their pelvis during childbirth also affect their feet. The hormone is called relaxin, and it allows bones to move and spread. Over time, it can cause the structure of a woman?s feet to gradually stretch and the metatarsal to shift.
The symptoms of a bunion include the following development of a firm bump on the outside edge of the foot, at the base of the big toe, redness, swelling, or pain at or near the MTP joint, corns or other irritations caused by the overlap of the first and second toes, restricted or painful motion of the big toe.
Diagnosis begins with a careful history and physical examination by your doctor. This will usually include a discussion about shoe wear and the importance of shoes in the development and treatment of the condition. X-rays will probably be suggested. This allows your doctor to measure several important angles made by the bones of the feet to help determine the appropriate treatment.
Non Surgical Treatment
Wide shoes with plenty of space for the toes are the first place to start. Along these lines, a shoe can be focally stretched directly over the painful bunion using a device known as a ?ball and ring? shoe stretcher. Additionally, numerous commercial bunion braces and splints are available to help keep the big toe in better alignment.
If bunions are causing severe foot pain or inflammation and swelling that limits daily activities and doesn't improve with rest, medication and comfortable shoes, surgery may be required. More than 100 surgical options are available for painful bunions. Some realign the foot's anatomy by cutting notches from the metatarsal bone or the bone of the big toe. The bones can then grow back without the slant that promotes bunion growth. The operation is usually done on an outpatient basis, but afterward, you probably will have to stay off your feet for a few weeks. Recovery takes about six weeks. Surgery is not recommended for a bunion that doesn't cause pain.
Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. Medicine will not prevent or cure bunions.