Why Do I Have Bunions?

posted on 31 Mar 2015 06:05 by brashpants2724
Overview

Bunions Callous

The best thing to say about the natural history of bunions is that they are unpredictable. This is both in terms of whether the bunion deformity will progress, and also whether the bunion will become painful (if it is not already painful). It would probably however be true to say that once a previously painfree bunion has started to become painful it is not common for the bunion to go back to being entirely pain-free.

Causes

By far the most common cause of bunions is the prolonged wearing of poorly fitting shoes, usually shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position. Bunions also may be caused by arthritis or polio. Heredity often plays a role in bunion formation. But these causes account for only a small percentage of bunions. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.

Symptoms

Pain in the toe joint and surrounding area. Painful to touch or press, and when walking. Growth of a bony lump (exostosis) at the side of the big toe joint. Irritated skin around the bunion. Redness. Thickening of overlying skin. Blisters may form more easily. Deformed bones, joints and ligaments as the big toe shifts towards the other toes. As the big toe shifts, its base becomes more prominent, forming the bunion. Eventually the big toe is forced to lie over, or more commonly under, the second toe. The second toe of patients who have bunions commonly forms a hammer toe. Trouble with shoes. It is difficult to find shoes that fit properly. Bunions may force you to buy a larger size shoe to accommodate the width the bunion creates. Eventually it hurts to wear any shoe, or even walk barefoot.

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

Treatment options vary depending on the severity of your bunion and the amount of pain it causes you. Early treatment is best to decrease your risk of developing joint deformities. Conservative treatment Nonsurgical treatments that may relieve the pain and pressure of a bunion include changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes. Padding and taping. Your Podiatrist can help you tape and pad your foot in a normal position. This can reduce stress on the bunion and alleviate your pain.(Obviously pending on footwear selection). Medications. Acetaminophen (Tylenol, others) can control the pain of a bunion. Your doctor may suggest nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve), for relieving pain and reducing inflammation. Cortisone injections also can be helpful. But keep in mind that medications do not alleviate the actual cause of the pain. Physical therapy. The heating effect of ultrasound therapy or whirlpool baths can provide relief from the pain and inflammation of a bunion. Orthotics can help control abnormal movement of your foot, reducing your symptoms and preventing your bunion from getting worse. Over-the-counter arch supports can provide relief for some people, though others may require prescription orthotics.

Bunion Pain

Surgical Treatment

When these above measures no longer help to relieve the pain in the big toe, surgery to correct the bunion deformity is considered. Numerous surgical procedures have been recommended for bunions. What is most critical is that the type of deformity is carefully evaluated, because one bunion surgery cannot be used for all types of bunions. If the big toe joint is rotated out of place, the joint must be rotated back in place for the procedure to work. Conversely, a bunion can occur with the big toe still ?in place.? If surgery is considered, the bunion must be corrected with the toe joint left in its current position. In other words, one type of bunion repair does not work for everyone. In all types of bunion repairs, ligaments and tendons (soft tissues) around the big toe joint are reconstructed, to allow the toe to be straightened. Most bunion procedures also require cutting the metatarsal bone, which is then fixed with metal screws to hold the bone in position until it heals. It usually takes 2 to 4 months to fully recover from bunion surgery, which is why it is always the last course of treatment.