Bunions

Bunions (Hallux Valgus) are common forefoot problems. It is a prominent bump on the inside of the foot near the big toe joint caused by a bone protruding towards the inside of the foot. Continual movement may cause the big toe to move towards the smaller toes. It is common to see overlapping toes where the big toe rests above or below the second toe. This common forefoot condition may result in painful swelling, redness, tenderness and soreness causing a person to walk improperly.

Tailor's Bunion, or a Bunionette, is a bunion that forms on the outside of the foot towards the joint at the little toe. A small bump forms due to the little toe moving inwards, towards the big toe. This condition is found less frequently.

Bunions result from abnormal bone formation in the first metatarsophalangeal joint and malalignment of the first toe. They can be related to inflammation or to degenerative disease (e.g., osteoarthritis) and alter the position of the toe. "Hallux abducto valgus" (HAV) is a term that refers to the hallux going away (abducting) from the midline of the body and twisting so the inside edge touches the ground and the outside edge turns upward.

Bunions worsen over time and cause discomfort, difficulty walking, and skin problems such as corns and lesions. A small fluid-filled sac (bursa) near the joint becomes inflamed (called bursitis), causing additional swelling, redness, and pain.

Causes of Bunions

Bunions are one of the most common foot problems. They often run in families which suggests that the inherited shape of the foot may predispose people to the condition.

Pronated feet (flatfoot) are unstable and often cause bunions. Body weight is repeatedly transferred to the hallux while walking, and in flat feet, causes certain muscles to be stronger than others. This overpowering of muscles causes the toe to bend and deform.

Women get bunions much more often than men and can be caused by tight, pointy-toed, or high-heeled shoes, and shoes that are too small. Women who have bunions normally wear dress shoes that squeeze their toes together causing the first metatarsal bone to protrude on the side of the foot. Improper shoes exacerbate the underlying cause of flat, unstable feet. It is important for both men and women to know that wearing dress shoes and boots, which are tapered in the toe area, can cause bunions to worsen to the point where surgery is necessary.

Progression
Typically, bunions begin as a cosmetic concern with a bump or outward bend of the big toe. However, the outward-bending toe stretches the ligaments that connect the foot bones and pulls against the tendons, drawing the toe farther out of line. Over time the big toe continues to twist until it no longer lines up properly with its corresponding metatarsal and the end of the metatarsal may become enlarged.

Pressure from the first toe can result in deformity of the metatarsalphalangeal joint in the second toe, pushing it toward the third toe. In some cases, the second toe may ride over or under the big toe. At this point, the range of motion in the big toe is decreased, which is a condition called hallux limitus and may also be painful.

The toe can bend at least 65 degrees altering the shape of the foot as well as the biomechanics of walking. In this case the big toe will be the last part of the foot to leave the ground while walking. However, with hallux limitus, the big toe cannot function properly and the body weight is transferred to the bunion.

Painful bunions cause the person to compensate by walking in a toe-turned-out manner, so the painful hallux does not have to bend as far. Walking with the feet turned out steadily forces the hallux even farther out, worsening the condition. Without treatment, the deformity eventually becomes disabling.

Treatment of Bunions

In the early stages of bunion formation, soaking feet in warm water can provide temporary relief. Wearing properly fitting shoes especially shoes with a high, wide toe box (toe area) is recommended for patients suffering from bunions. Shoes with rocker soles will unload pressure to the bunion area. Orthotics are also recommended for this condition to provide extra comfort, support, and protection.

Bunion shields, bunion night splints, and bunion bandages are other forefoot products designed to help alleviate bunions. These conservative treatments can limit the progression of bunion formation, relieve pain and provide a healthy environment for the foot.

A bunion is a gradual dislocation of the great toe joint causing the big toe to slant outward at an angle, disfiguring the foot. The foot structure that predisposes a child to bunions is usually inherited. Irritation, swelling, and redness occur by wearing shoes that are too narrow in the forefoot and toe area can contribute to bunion formation. Wearing high heels often and for long periods can also contribute to bunion development. Bunions are the purest form of degenerative arthritis in older people. Because of the constant stress on the area there is increased vascularity, commonly thought to be the reason that gout most frequently first develops in the great toe joint. Bursitis is caused by an irritation of the anatomical bursa, located on the inside of the great toe. This can be very painful, yet can be treated by wearing shoes that don't cramp the ball of the foot and toe area or by soaking the feet in warm water to relieve discomfort. But the best way to approach bunions (which are created by the inability to control the heel, which controls the central part of the foot which in turn contributes to forefoot deformities) is wearing orthotics. Insole Orthotic is specifically designed to help reduce pain and discomfort in the great toe joint area and to stabilize the foot to allow bunions that have started to slow down the progressive change in development throughout life.

This material is only provided as helpful information and you should always go to your medical doctor or podiatrist for a professional diagnosis.