A bunion is an often painful enlargement of bone or tissue around the joint at the base of the big toe. If you have a bunion, you will notice a bump on your big toe joint. The big toe may turn in toward the second toe and the tissues surrounding the joint may be swollen and tender. Bunions can come from a variety of causes, including diabetes, rheumatoid arthritis, or foot mechanics that place too much load on the ball of your foot. If untreated, bunions can worsen, leading to other serious complications, and even potentially require surgery. Early treatment is best, so if you?re suffering from bunions it?s smart to see a podiatrist for proper treatment and care.
The most common cause of bunions is wearing shoes that are too tight. The condition is not hereditary, but it does tend to run in families-often due to a faulty foot structure. Other causes of this condition might be neuromuscular problems, flat feet, pronated feet, or foot injuries.
A bunion, also called a hallux valgus, is a bony prominence on the inside of the big toe, caused by a misalignment of the joint. The overlying skin maybe swollen, red and tender. Bunions are often painful and can limit what shoes you can wear.
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.
Non Surgical Treatment
Wearing the right shoes, using shoe inserts (orthoses) and padding, and taking painkillers can all help to ease your symptoms of a bunion. However, these treatments can?t cure a bunion or stop it getting worse. If you have severe pain or discomfort from a bunion, you may be advised to have an operation to correct it. One of the most important things you can do is to wear the right footwear. You should try to wear flat, wide-fitting shoes with laces or an adjustable strap that fits you properly. You may also want to place a bunion pad over your bunion to give it some protection from the pressure of your shoes. You can usually buy these pads from a pharmacy, or get them from your podiatrist or chiropodist. He or she may also recommend a shoe insert, which can be moulded specifically to your foot. Shoe inserts aim to reduce the pain of your bunion by improving how you walk. You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to help relieve the pain and inflammation of your bunion. Always follow the instructions in the patient information leaflet that comes with your medicine. Medicines give temporary relief but they won?t be able to cure your bunion or prevent it from getting worse. If you have a bunion as a result of underlying arthritis, your doctor may prescribe specific medicines to treat this.
If the bunion symptoms does not respond to the conservative measures or if the bunion has progressed past a threshold where these measures are not effective, bunion surgery may be necessary to correct alignment and remove the bunion. A large range of types of surgical procedures for bunions are available and the choice will depend on things like what bone or bones are involved, the angular relationship between the different bones, the amount of damage to the joint and the presence of deformities other than the bunion.