What Exactly Are Bunions?

posted on 05 Jun 2015 21:15 by parkerdfwbuwenbe
Overview
Bunion Pain What most people call a bunion is actually known as "Hallux valgus". Hallux valgus refers to the condition in which the big toe is angled excessively towards the second toe and a bunion is a symptom of the deformity. In a normal foot, the big toe and the long bone that leads up to it (the first metatarsal) are in a straight line. However, Hallux valgus occurs when the long foot bone veers towards your other foot and your big toes drifts towards your second toe. A bunion actually refers to the bony prominence on the side of the big toe. This can also form a large sac of fluid, known as a bursa, which can then become inflamed and sore.

Causes
There are many factors which can contribute to the development of a bunion. The common causes are genetic factors, poor foot mechanics, high-heeled or narrow footwear and trauma to the toe. It is believed that constant stress on the joint of the big toe causes mild displacement of the bones and the joint, along with thickening of the tissues and a change in the pull of the muscles. This can result in a degree of arthritis of the joint, and over time, further displacement of the toe. This may lead to pain, difficultly with fitting shoes and corns/calloused lesions due to excess pressure on the smaller digits.

Symptoms
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.

Diagnosis
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI's are not usually required.

Non Surgical Treatment
There are two ways to treat this pathological foot conditions, conservatively and surgically. Conservative treatment is the first line treatment which consists of splints and orthotic care to reduce the causative factors. Realigning the foot with the aid of an orthotic helps prevent further degeneration and/or reduce symptoms of HAV in any stage of its deformity. Along with orthotic care, patients may require debridement of corns and calluses produced due to extra forces produced on the foot. Orthotics will also help the function of the big toe joint as it allows it to bend in the correct position. Footwear advice is also essential in the conservative care of bunions, HAV, there may be a need to change footwear, so it is able to fit properly and be compliment with orthotics. Surgical correction of bunions, HAV is available, however should only be considered when conservative care has failed to reduce the onset of bunions, HAV. It is only considered if there is a clear sign that it will induce a better quality of life for the patient. Bunions

Surgical Treatment
If surgery is required to correct a symptomatic bunion, there are several procedures that may be used, depending on the size and degree of the deformity. For mild deformities, a simple shaving of the bony prominence may suffice. At the same time, the tissues on the inner, or medial, side of the joint are tightened to hold the great toe in a more neutral alignment. When only the bone is shaved, this procedure is commonly referred to as a ?Silver? procedure. When the bone is shaved and the soft tissues tightened, this is called a ?modified McBride? procedure.

Prevention
Wear insoles and well-fitting shoes to help slow down the progression of bunions and alleviate discomfort. Cushioning can also help alleviate discomfort. Consider wearing shoes with a wide toe box so they don't crowd your toes. Children can also develop bunions and should wear properly fitting shoes as their feet are still developing.
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