A hallux abducto valgus deformity, commonly called a bunion, is a deformity characterized by medial deviation of the great toe, often erroneously described as an enlargement of bone or tissue around the joint at the head of the big toe. There is disagreement among medical professionals about the cause of bunions; some see them as primarily caused by the long-term use of shoes, particularly tight-fitting shoes with pointed toes, while others believe that the problem stems from genetic factors that are exacerbated by shoe use. Bunions occur when pressure is applied to the side of the big toe (hallux) forcing it inwards towards, and sometimes under or over, the other toes (angulation). As pressure is applied, the tissues surrounding the joint may become swollen and tender. In a survey of people from cultures that do not wear shoes, no cases of bunions were found, lending credence to the hypothesis that bunions are caused by ill-fitting shoes. The bump itself is partly due to the swollen bursal sac or an osseous (bony) anomaly on the metatarsophalangeal joint. The larger part of the bump is a normal part of the head of the first metatarsal bone that has tilted sideways to stick out at its top.
Bunions occur with greater regularity in women than men, and they may sometimes run in families. You may also have an increased likelihood of bunions if you are born with certain bone abnormalities in your feet. Factors that may increase your chances of developing a bunion include long-term use of narrow-toed and/or high-heeled footwear. Arthritis. Toe trauma. Laxity of your connective tissues (ligament laxity). Limb length inequalities. Genetics. Certain foot problems (e.g. flatfoot, over-pronation, etc.).
The dominant symptom of a bunion is a big bulging bump on the inside of the base of the big toe. Other symptoms include swelling, soreness and redness around the big toe joint, a tough callus at the bottom of the big toe and persistent or intermittent pain.
Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
The first step in the treatment of Bunions, Corns, and Calluses is determining what is causing the problem. Check with your family doctor or Podiatrist (foot doctor) to find the best solution for your ailment. You can reduce the risk of Bunions, Corns, and Calluses by following these simple instructions. Wear properly-fitting footwear, socks, and stockings (not too tight or too loose). Wear footwear with a wide toe box (toe area). Wear footwear or arch supports which provide proper support, weight distribution, and shock absorption. Maintain a healthy weight. For early-stage Bunions, soaking your feet in warm water can provide temporary relief.
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it?s time to discuss surgical options with a foot and ankle surgeon. Together you can decide if surgery is best for you. A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the ?bump? of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.
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