A bunion is enlargement of bone or tissue that develops at the joint that connects your big toe to your foot. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and running. When the joint, called the metatarsophalangeal joint, or MTP joint, experiences abnormal, prolonged stress in terms of weight distribution or squeezing of the toes within the shoe, the result can be the deformity called a bunion. Generally, a bunion develops when, as a response to prolonged stress, your big toe begins bending toward your foot's smaller toes and puts pressure on your MTP joint, forcing it to bulge outward (the term "bunion" comes from the Latin word for "enlargement"). There is no "standard" bunion, however, but rather a complex range of joint, bone and tendon abnormalities that can cause variation in each bunion's make-up.
Despite the popular belief, wearing high heels and too-narrow shoes does not cause bunions. Wearing them can irritate, aggravate, or accelerate the formation of the bunion, but are not the root cause. Bunions are more commonly inherited, if your parents or grandparents had bunions, you may also get one. Bunions can also be caused by trauma or injury to the joints, ligaments, or bones of the foot.
SymptomsThe main problem is usually the pressure of the shoe over the bony prominence, which causes discomfort or pain. Sometimes the skin over the lump becomes red, blistered or infected. The foot may become so broad that it is difficult to get wide enough shoes. The big toe sometimes tilts over so much that it rubs on the second toe, or pushes it up out of place so it presses on the shoe. Also, the big toe does not work as well with a bunion, and the other toes have to take more of the weight of the body as you walk. This can cause pain under the ball of the foot ("metatarsalgia"). Sometimes arthritis develops in the deformed joint, causing pain in the joint.
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
Several things can be done to help relive the pain of bunions. These won't make the bunion go away, but they can make the foot more comfortable. Wearing different shoes. Shoes with a wide toe box rather than a pointed one will help. Shoes with lower heels will also help. (High heels throw more of the body's weight on the front part of the foot where the toe joints are.) Padding. Pads placed over the bunion may help reduce the pain. These are available from a drug store or may be available from a foot and ankle surgeon. Avoiding activities that make the pain worse. This includes standing for a long time or other activities that make the bunion sore. Non-steroidal anti-inflammatory drugs. These include aspirin or ibuprofen. They relieve pain and swelling. Applying an ice pack to reduce swelling and pain. Corticosteroid injections. These are not often used in bunion treatment. Injecting corticosteroids sometimes helps if the bursa is inflamed. (Bursa is a fluid-filled sac within a joint to cushion the bones). Orthotic devices. These are devices placed inside a shoe that shift the positioning of the foot. Orthotics help compensate for structural issues that cause foot problems.
For severe bunions, outpatient surgery may be recommended. Within hours after surgery, you?ll be on your way home and ready for recovery. Your foot will be bandaged following surgery and placed in a surgical shoe which allows you to remain mobile. Immediate weight bearing without the use of casting or crutches is standard post- operative recovery for bunions. In most cases, the majority of healing should occur within a few weeks and you can resume normal activity within a short period of time. Bunion surgery can both reduce pain and improve the appearance of your feet. After surgery it is important to see your podiatrist as scheduled and follow all recovery instructions.