Bunion

Hallux valgus is a condition when the big toe of the foot called the hallux starts to deviate inward towards the direction of the little toe. As the big toe drifts over into valgus, a bump starts to develop on the inside of the big toe over the metatarsal bone. This bone prominence on the inner edge for the metatarsal is referred to as a bunion.
bunion

Symptoms

The signs and symptoms of a bunion include:

  • A bulging bump on the outside of the base of your big toe
  • Swelling, redness or soreness around your big toe joint
  • Thickening of the skin at the base of your big toe
  • Corns or calluses — these often develop where the first and second toes overlap
  • Persistent or intermittent pain
  • Restricted movement of your big toe

Pain from a bunion can be severe enough to keep you from walking comfortably in normal shoes. The skin and deeper tissue around the bunion also may become swollen or inflamed.

By pushing your big toe inward, a bunion can squeeze your other toes into abnormal positions. Over time, this crowding molds the four toes into the bent or claw-like shape known as hammertoe.

What are the Causes?

Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot.

Causes of bunions include:

  • High-heeled or ill-fitting shoes
  • Inherited foot type
  • Foot injuries
  • Deformities present at birth (congenital)

Bunions may be associated with various forms of arthritis, including inflammatory or degenerative forms, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause.

What are the Treatments?

Treatment options vary depending on the severity of your bunion and the amount of pain it causes you.

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 doctor can help you tape and pad your foot in a normal position. This can reduce stress on the bunion and alleviate your pain.
  • Medications. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve) may help control the pain of a bunion. Cortisone injections also can be helpful.
  • Shoe inserts. Padded shoe inserts can help distribute pressure evenly when you move your feet, 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 orthotic devices.

Surgical options
If conservative treatment doesn’t provide relief from your symptoms, you may need surgery. A number of surgical procedures are performed for bunions, and no particular surgery is best for every problem. Knowing what caused your bunion is essential for choosing the best procedure to ensure correction without recurrence.

Most surgical procedures include a bunionectomy, which involves:

  • Removing the swollen tissue from around your big toe joint
  • Straightening your big toe by removing part of the bone
  • Realignment of the long bone between the back part of your foot and your big toe, to straighten out the abnormal angle in your big toe joint
  • Permanently joining the bones of your affected joint

It’s possible you may be able to walk on your foot immediately after a bunion procedure. However, full recovery can take up to eight weeks or longer with some bunion procedures. To prevent a recurrence, you’ll need to wear proper shoes after recovery.

Surgery isn’t recommended unless a bunion causes you frequent pain or interferes with your daily activities. A bunionectomy — like other types of surgery — is not without risk. Additionally, you may still have pain or you could develop a new bunion in your big toe joint after surgery. Consider trying conservative treatment before having a bunionectomy.

Get Treated Today

Dr Kevin Yip is an orthopaedic surgeon/professor

He has more than 20 years experience in treating orthopaedic problems ranging from common orthopaedic problem, sport injuries to degenerative changes of orthopaedic problem.
Be assured that you will be receiving professional treatments that suit your needs.

Get Treated Today