A bunion is a very common foot deformity that develops over the first metatarsal phalageal joint of the big toe of the foot. The joint that joins the big toe to the foot is called the first MTP joint. When it becomes prominent and the big toe starts to become crooked this is known as a bunion. The term referring to deformity of the big toe as it becomes crooked is called Hallux Valgus. It is the bump itself that is known as the bunion. When it gets red and swollen over the bunion because it gets sore this is usually due to an inflamed soft tissue over the underlying bone.
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.
SymptomsRed, thickened skin along the inside edge of the big toe. A bony bump at this site. Pain over the joint, which pressure from shoes makes worse. Big toe turned toward the other toes and may cross over the second toe.
Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.
Non Surgical Treatment
Separating the big toe and the next one with a 1 cm thick piece of foam can relieve painful symptoms. This can be fixed in place with some zinc oxide plaster tape and has the effect of straightening the great toe and relieving pressure on the bunion. A taping technique will support the joint and relieve the pressure on the inside of the foot. Off the shelf orthotic insoles can be worn to help correct any biomechanical problems in the foot which may be causing the problem. If the foot rolls in or over pronates then this causes the arch of the foot to flatten and more pressure is placed on the base of the big toe where the bunion forms. A podiatrist is a therapist who specializes in feet. They can do a full gait analysis and make orthotic inserts to correct biomechanical foot problems. Severe cases may require surgery to realign the joint but this is a last resort if conservative treatment has failed.
Research shows that 85% of people who have bunion corrections are satisfied with the results. However, a number of problems can arise. The big toe is usually stiffer than before. For most people this does not matter, but for athletes or dancers it is very important. As mentioned before, the big toe is slightly weaker with a bunion, and this transfers weight onto the ball of the foot. After bunion surgery, this transfer of weight can increase. Therefore, if you have pain under the ball of the foot (“metatarsalgia”) it may be worse after bunion surgery, and it may also develop for the first time. Careful surgical technique can reduce this risk, but it cannot avoid it completely. Most people who develop metatarsalgia are comfortable with a simple insole in the shoe but occasionally surgery is required. In some people the big toe slowly tilts back toward the original position and occasionally this is bad enough to need to have the operation redone. On the other hand, the toe can tilt the other way, though much more rarely. Again, occasionally this is bad enough to need to have the operation redone. Infections in the wound, plaster problems and minor damage to the nerves of the toe can occur in any foot surgery. Usually these are minor problems that get better quickly. This may sound like a lot of possible problems, but in fact most people do not get them and are satisfied with their bunion surgery. However, this may help you to see how important it is to have any bunion surgery carried out by a properly trained and experienced foot and ankle surgeon.