Bunions are a common problem that most individuals experience as a painful swelling or a bony protuberance at the inner base of the big toe. This condition is the result of a malalignment of the first toe. These can be hereditary or secondary to wearing high-heeled or narrow toe-box shoes.
Contributing factors may include excessive foot pronation, wearing tight and pointed-toe shoes, and occasionally trauma. Joint misalignment causes osteoarthritis with cartilage erosion and exostosis formation, resulting in joint motion being limited (hallux limitus) or eliminated (hallux rigidus). In late stages, synovitis occurs, causing joint swelling. In reaction to pressure from tight shoes, an adventitious bursa can develop medial to the joint prominence, which can become painful, swollen, and inflamed.
Movement of the big toe towards the smaller toes. Bulging bump on the outside of the base of the big toe. Restricted movement of the big toe. Swelling, inflammation, redness or soreness around your big toe joint. Persistent or sporadic dull, sharp or aching pain in or around the big toe. Corns, blisters and calluses which can develop when the first and second toes overlap. Over time, more severe symptoms can occur such as arthritis of the big toe, stress fractures and problems walking.
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by Arthritis, which causes destruction of the cartilage of the joint. Gout, which causes the accumulation of uric acid crystals in the joint. Tiny fractures of a bone in the foot or stress fractures. Infection. Your doctor may order additional tests to rule out these possibilities.
Non Surgical Treatment
There are many treatment options for bunions and they will vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time, how fast this happens may be a function of the fit of the footwear. The initial goal of treatment options is to relieve pressure on the bunion and any symptoms that may be present and to halt or slow the progression of the joint deformity. There is no effective may be "get rid off" a bunion without surgery. There are a number of things that individuals and Podiatrists can do to help the symptoms and slow (if not halt) progression.
In severe hallux valgus bunion cases, the first long bone (metatarsal) in the foot dramatically shifts away from the second metatarsal, resulting in looseness and a large deformity. In severe bunion corrections, a surgery known as the Lapidus procedure realigns the first metatarsal into its natural position. Using screws, the surgery holds the bone stable so it does not shift again and reduces the change of the bunion returning to basically none. Surgery may also involve removing the enlarged portion of the bunion region, cutting and realigning the bone, and correcting the position of the tendons and ligaments. By using a special plate with Lapidus procedures, University Foot and Ankle Institute patients are able to put weight on their foot after only 2-3 weeks, rather than the typical 6-8 weeks of no weight.