A bunion is a bony bump that forms on the joint at the base of your big toe. It occurs when some of the bones in the front part of your foot move out of place. This causes the tip of your big toe to get pulled toward the smaller toes, forcing the joint of your big toe to stick out. The skin over the bunion may be red and sore. The technical term for bunions is hallux valgus. Here are the causes and symptoms of bunions and how they’re treated.
Bunions develop because of a structural problem in the foot and toes, usually the MTP joint. As a result, the feet no longer line up properly. Bunions may also occur near the base of the little toe and when they do, they’re called bunionettes or tailor’s bunions. There are many theories about how bunions develop but the cause is yet unknown. The factors linked to their development are:
- Inherited foot type
- Foot stress or injuries
- Deformities present at birth
- Hypermobility i.e., having a big toe bone that moves more than usual
- Overpronation i.e., having a low arch or uneven weight bearing in the foot and tendon making the toe joint unstable
- Types of arthritis such as rheumatoid arthritis
- Conditions that affect both nerves and muscles such as polio
High heels and ill-fitting narrow shoes promote the growth of bunions. They don’t directly cause them, but they aggravate already-existing bunions and are likely to cause bunions to develop in people with a genetic risk of developing them
Symptoms of bunions
- Pain and soreness
- Swelling at the joint of the affected toe
- Inability to bend the big toe or pain and burning sensation when you try to
- Corns or calluses (thickened skin)
- Hardened skin under the foot
- Hammertoes (painful, tight toe tendons and joints)
- Numbness in the big toe
- Bump on the base of the affected toe
- Difficulty wearing regular shoes
Diagnosis, management, and treatment
A healthcare provider can diagnose a bunion just by looking at it. In some cases, you can get an X-ray to check for joint damage and bone alignment. Bunions don’t go away, and treatment is often focused on relieving the symptoms.
Changing shoes: this is the first line of treatment for bunions.
Toe spacers and splints: these are placed between the toes and can help with alignment and symptoms. Some people find relief from wearing a splint at night to keep the big tie straight.
Bunion pads: over-the-counter bunion pads can cushion the area and ease pain
Medical tape: taping the large toe onto the other toes helps keep the foot in the correct position
Medication: over-the-counter medication can help with the pain and the inflammation easing the swelling and the pain
Orthotic devices: this refers to custom-made shoe inserts (orthotics) which can help control alignment issues such as pronation which may be contributing to bunion formation.
Ice: can help decrease inflammation. Heat is not recommended to be used directly on bunions, but you can use heat to relax the rest of the foot and calf.
Physical therapy: massage, physical, and ultrasound therapy can be used to reduce pain and inflammation. Physical therapy can help improve the functioning of the foot muscles. A physical therapist can also recommend useful calf and foot stretches.
Injections: steroid injections to the bunion may reduce pain and swelling but can also be damaging if used too often or injected into the joint itself. This is often used in late treatment to avoid surgery.
Surgery: if non-surgical treatment doesn’t help and walking becomes extremely painful, your doctor may recommend surgery. In this procedure called a bunionectomy, the surgeon removes the bunion and realigns bones to bring the toe back into the correct position.
The best way to prevent bunions barring changing your genetics is wearing proper-fitting footwear. Go for shoes with a wide toe box and soft soles. Avoid shoes that are narrow and pointed at the tip. Avoid high heels because they put pressure on the front of the foot.
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