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Nov 16, 2007 - BunionsBack
BUNIONS
Definition:
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot at the big toe joint. This bump is actually a big toe joint protruding towards the inside of the foot.
As the big toe moves towards the smaller toes, in some severe cases, it may dislocate in such a way that the big toe rests under or over the second toe. This will result in a forefoot condition called overlapping toes and can lead to a number of problems including pain and footwear difficulties. Symptoms from bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort may be significant and can in some cases lead to disability in walking.
Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot and involves the joint at the little toe. It is a smaller bump and is a result of the little toe moving inwards, towards the big toe and the little toe joint moving outwards.
Cause:
Bunions affect women more than men. The deformity can develop as a result of wearing improper footwear. Tight, narrow dress shoes with constrictive toe box (toe area) may cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion.
Women who have bunions normally wear dress shoes that are too small for their feet. Their toes are squeezed together in the shoes causing the first metatarsal bone to protrude on the side of the foot.
However we all know of the situations where people wear bad shoes but do not suffer with bunions and those that have worn good shoes all of their lives and still have bunions. The reason for this is the presence of some type of instability within the foot structure. This may have been present from birth (congenital) or acquired (developed in later years). Most specialists believe this is due to poor foot mechanics which causes instability around the big or little toe resulting in progressive deformity.
This biomechanical imbalance may be inherited from parent(s) (which explains why bunions often run in families) or may have developed as a result of injury or disease such as arthritis.
Treatment & Prevention:
This condition can be managed in a number of ways ranging from self-care, conservative treatments to surgery. Self-care can take the form of improving footwear styles which accommodate the deformity and reduce pressure on prominent joints. There is an array of over the counter pads and dressing that may provide temporary relief from symptoms. Soaking the feet in warm water and gently massaging the forefoot may also provide temporary relief.
Prescription foot orthoses are an effective way of dealing with certain types of bunions and bunionettes. Once the biomechanical factors have been identified the orthoses may be designed to provide motion control to reduce the stress going through the big and little toe joints, thereby stabilizing the joint and removing the cause of the bunion. Such treatments if given early enough can prevent the deformity from progressing to a point where it becomes painful and troublesome.
Furthermore, in families where there is a history of bunions we may be wise to have children assessed at the earliest opportunity. Identifying any biomechanical faults and addressing them at an early age may prevent the development of the bunion.
Surgery – If the objective is to reduce the size of the bunion or bunionette then some cases may benefit from surgery. The overall function of these joints should be given top priority.
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