A bunion is a bony enlargement of the joint and surrounding soft tissues at the base of the big toe. The enlargement makes the big toe joint stick out further on the side, and forces the big toe to curve in closer to the other toes. For some people, bunions cause little or no pain. In Canada, women are 10 times more likely than men to have bunions. Managing the condition so that it doesn't get worse is a matter of wearing appropriate footwear, cushioning and supporting the area, and taking pain relievers as required. People with more severe bunions may need more specific treatment, such as surgery.
Bunions develop when excess pressure is placed on the tendons and joints of the foot. As a result, the joints can become deformed and unstable. After years of pressure, the MTP joint suffers, leading to abnormal movement and bunions. Bunions are symptomatic of poor foot development (which can be genetic), walking habits, shoes, foot type and other reasons. Women often develop bunions as a result of tight shoes that squeeze the toes together. Bunions can also result from foot injuries, congenital deformities and neuromuscular disorders. Flat foot and low arch problems are often precursors to bunions, as are problems with serious arthritis or inflammatory joint disease. An overlap of the first and second toes often causes irritation and corns and can eventually lead to bunions. Poor motion of the big toe can also be a factor.
SymptomsThe major symptom of bunions is a hard bump on the outside edge of the foot or at the base of the big toe. Redness, pain and swelling surrounding or at the MTP joint can also occur.
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
Non-surgical treatments for bunions may include wearing shoes that fit and that have adequate toe room. Stretching shoes professionally to make them larger. Putting bunion pads over the bunion to cushion the pain. Avoiding activities that cause pain, such as being on your feet for long periods of time. Taking over-the-counter pain relievers when necessary, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen. Using ice to provide relief from inflammation and pain. Using custom-made orthotic devices.
Bunion surgery can be performed under local or general anaesthetic. The operation usually takes between half an hour to an hour. There are several types of bunionectomies. Some involve removal and realignment of the bones in your foot. Mild bunion problems can sometimes be resolved using soft tissue release or tightening. For some very severe cases bones of the big toe are fused or the bunion is cut out along with some of the bone at the base of the toe. Be sure and discuss which type of operation you will have with your surgeon. With any type of bunionectomy your surgeon will make one or more incisions (cuts) near your big toe. They will use instruments to trim the bones and remove the bunion. Wire, screws or plates may also be used to hold the new joint in place.