Overview
The original definition of a bunion was a bursa (a fluid-filled sac) on the side of the foot near the base of the big toe. The bursa was caused by a chronic friction of the patient's first metatarsal bone (the bone to which the big toe attaches) and the shoe. Few people go by this definition any longer. Today most people consider a bunion to be the enlarged bone on the side of the foot that typically caused the bursa. Along with this bump, there is usually an associated mis-alignment of the big toe, with it leaning in towards the second toe. In medical jargon, the term for a bunion is "Hallux Abducto Valgus," or "HAV" for short. Though the condition is really slightly different, it may also be known as "Hallux Valgus." Bunions are usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly. This is usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly.
Causes
What causes bunions? This question is often answered by blaming shoes. But in fact, shoes only play a small role in developing bunions. Yes, shoes, especially high heels cause abnormal squeezing of your forefoot. This in turn to help promote a bunion. But if everyone who wore high heels shoes had a bunion, there would be a lot more then the 15% prevalence we see in the general population. As you can see from the flow chart, genetics plays the major role in development of bunion deformities. Genetics determines the way your foot functions. Are you flatfooted? Are your joints flexible or stiff? Do you have a high arch? Do you have tight muscles? These traits are determined by your genetic code. These characteristics then govern how your bones and joints move when you walk. As an example, if your joints are very flexible, this can cause an abnormal amount of instability in your forefoot when you walk. Over time, this abnormal motion will cause the a bunion to develop by allowing your first metatarsal to "drift" towards the mid-line of your body.
Symptoms
Symptoms include redness, swelling and pain which may be present along the inside margin of the foot. The patients feet may become too wide to fit into their normal size shoes and moderate to severe discomfort may occur when the patient is wearing tight shoes. A "hammer toe" may occur at the 2nd toe. This is when the toe contracts and presses on the shoe. Subsequently, this may cause a corn on top of the 2nd toe.
Diagnosis
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
The choice of treatment for a bunion lies between non-operative (conservative) and operative treatment. Conservative treatment for a bunion means either wearing wider fitting shoes or shoes with softer leather or using some form of a spacer between the big toe and 2nd toe (or alternatively some form of splint to keep the great toe away from the 2nd toe). The spacers or splintage may apparently straighten the bunion but they make no difference to the width of the foot, and the splaying of the 1st and 2nd metatarsals which occur with a bunion deformity. Therefore this type of treatment will not improve the main pain in a bunion which occurs due to the width of the forefoot. An arch type support orthotic may be useful if a bunion is associated with a flatter foot. If you have a bunion this is however just one other thing to get into a shoe with an already wide foot.
Surgical Treatment
The decision to have bunion surgery is personal and different everyone. While there are many reasons to have bunion surgery, the most common reasons include. Pain. Difficulty walking. Difficulty fitting shoes. Worsening bunion. Pain at the ball of the foot. Failed conservative measures. See Non-surgical Treatment. Some people have surgery simply because they don?t like the way the bunion looks. While some doctors may correct your bunion if it doesn?t hurt, you should be aware that permanent pain may occur after your surgery.
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.
The original definition of a bunion was a bursa (a fluid-filled sac) on the side of the foot near the base of the big toe. The bursa was caused by a chronic friction of the patient's first metatarsal bone (the bone to which the big toe attaches) and the shoe. Few people go by this definition any longer. Today most people consider a bunion to be the enlarged bone on the side of the foot that typically caused the bursa. Along with this bump, there is usually an associated mis-alignment of the big toe, with it leaning in towards the second toe. In medical jargon, the term for a bunion is "Hallux Abducto Valgus," or "HAV" for short. Though the condition is really slightly different, it may also be known as "Hallux Valgus." Bunions are usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly. This is usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly.
Causes
What causes bunions? This question is often answered by blaming shoes. But in fact, shoes only play a small role in developing bunions. Yes, shoes, especially high heels cause abnormal squeezing of your forefoot. This in turn to help promote a bunion. But if everyone who wore high heels shoes had a bunion, there would be a lot more then the 15% prevalence we see in the general population. As you can see from the flow chart, genetics plays the major role in development of bunion deformities. Genetics determines the way your foot functions. Are you flatfooted? Are your joints flexible or stiff? Do you have a high arch? Do you have tight muscles? These traits are determined by your genetic code. These characteristics then govern how your bones and joints move when you walk. As an example, if your joints are very flexible, this can cause an abnormal amount of instability in your forefoot when you walk. Over time, this abnormal motion will cause the a bunion to develop by allowing your first metatarsal to "drift" towards the mid-line of your body.
Symptoms
Symptoms include redness, swelling and pain which may be present along the inside margin of the foot. The patients feet may become too wide to fit into their normal size shoes and moderate to severe discomfort may occur when the patient is wearing tight shoes. A "hammer toe" may occur at the 2nd toe. This is when the toe contracts and presses on the shoe. Subsequently, this may cause a corn on top of the 2nd toe.
Diagnosis
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
The choice of treatment for a bunion lies between non-operative (conservative) and operative treatment. Conservative treatment for a bunion means either wearing wider fitting shoes or shoes with softer leather or using some form of a spacer between the big toe and 2nd toe (or alternatively some form of splint to keep the great toe away from the 2nd toe). The spacers or splintage may apparently straighten the bunion but they make no difference to the width of the foot, and the splaying of the 1st and 2nd metatarsals which occur with a bunion deformity. Therefore this type of treatment will not improve the main pain in a bunion which occurs due to the width of the forefoot. An arch type support orthotic may be useful if a bunion is associated with a flatter foot. If you have a bunion this is however just one other thing to get into a shoe with an already wide foot.
Surgical Treatment
The decision to have bunion surgery is personal and different everyone. While there are many reasons to have bunion surgery, the most common reasons include. Pain. Difficulty walking. Difficulty fitting shoes. Worsening bunion. Pain at the ball of the foot. Failed conservative measures. See Non-surgical Treatment. Some people have surgery simply because they don?t like the way the bunion looks. While some doctors may correct your bunion if it doesn?t hurt, you should be aware that permanent pain may occur after your surgery.
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.