Dealing With Bunions

Overview
Bunions Callous A bunion (from the Latin 'bunion', meaning enlargement) is a protuberance of bone around the big toe joint. The enlargement can also occur at the outside of the foot, at the base of the little toe. This is called a tailor's bunion or bunionette. As a bunion deformity progresses with time, an enlargement increases in size behind the big toe, making shoe wear difficult and painful. Consequently, the big toe will shift position and move over or under the toes next to the big toe. Bunions can occur at any age between childhood and the golden years. The occurrence of bunions are far more prominent in women than men. Ill fitting narrow shoes and shoes with heels tend to aggravate bunions and cause them to occur at a higher incidence.

Causes
Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function, or arthritis, but is more commonly caused by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can 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 their shoes causing the first metatarsal bone to protrude on the side of the foot. It is important for men and women to realize that wearing dress shoes and boots, which are tapered in the toe area, can cause the bunion to worsen to the point where surgery is necessary.

Symptoms
Audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. Inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint. Pain at the side and top of the joint that worsens with walking and physical activity.

Diagnosis
Your family doctor or chiropodist /podiatrist can identify a bunion simply by examining your foot. During the exam, your big toe will be moved up and down to determine if your range of motion is limited. You will be examined for signs of redness or swelling and be questioned about your history of pain. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen. A X-ray of your foot may help identify the cause of the bunion and rate its severity.

Non Surgical Treatment
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include the use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems. Removal of corns and calluses on the foot. Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth. Orthotic devices, both over-the-counter and custom made-to help stabilize the joint and place the foot in the correct position for walking and standing. Exercises to maintain joint mobility and prevent stiffness or arthritis. Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable. Bunions

Surgical Treatment
If other treatments don?t help and your bunion is very painful, you may be referred to an orthopaedic or a podiatric surgeon for assessment. There are over 130 different operations that can be carried out to treat bunions. The simplest operations are called bunionectomies. The majority of the operations aim to correct the alignment of your big toe. This will narrow your foot and straighten out your big toe joint as much as possible. An operation won?t return your foot back to normal, but most people find that surgery reduces their symptoms and improves the shape of their foot. The operation your surgeon will advise you to have will depend on how severe your bunion is and whether or not you have arthritis.

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.