Bunion

A bunion is a swelling on the foot, usually located at the joint of the big toe. Often, a bony protuberance is present at the joint of the big toe, which gives the bunion its bulging appearance.

Causes

Bunions are most commonly caused by wearing poorly fitting footwear, but they can also be the result of inherited deformities in bone structure of the foot. In a normal foot, the two main bones of the big toe must align to fit together. However, some people have loose joints in the foot that allow their big toes to point toward the other toes.

This inherited condition causes problems when footwear forces the big toe inward and the big-toe joint outward. Friction from the joint rubbing against the inner surface of the shoe can produce a bunion. The same action results when a tight or pointed-toe shoe puts pressure on the joint -- regardless of whether or not the person has loose joints in the foot.

Symptoms

A bunion is characterized by swelling at the big-toe joint, which may be accompanied by pain and tenderness. Bunion formations can be acute or chronic. Acute bunions are a type of bursitis, which is an inflammation of a bursa (a fluid-filled sac that cushions joints). With an acute bunion, the bursa covering the big-toe joint becomes inflamed from friction, often producing considerable discomfort. Chronic (long-term) bunions develop into inflexible bony protrusions.

Complications

Complications can occur if the bunion grows and increases the pressure on the big toe. This pressure may force the other toes to overlap, encouraging the development of corns (mounds of dead skin) or other problems that result from friction among the distorted toes.

Diagnosis and Treatment

A physician diagnoses a bunion by general physical examination. To identify bone problems, an X-ray examination may be necessary.

Surgery is the only permanent cure for bunions. The procedure may entail the simple removal of the excess bone. Local anesthetic is often used and pain from surgery is minimal. With this treatment, the patient has full use of the foot again in about six weeks.

More extensive surgery requires a complex realignment of the affected bones, muscles, and tendons. The patient is admitted to the hospital, and the recuperation time is longer. Usually, an orthopedic surgeon performs this type of surgery.

Nonsurgical devices can often relieve the pain and discomfort of bunions. Padding can shift the weight of the foot in the shoe, lessening friction. Protective shields can also prevent contact between the bunion and the inside of the shoe.

Prevention

Wearing properly fitting footwear is the best preventive measure. A child's first shoes should be wide enough to accommodate all the toes without cramping, since early childhood is when many foot problems begin.

When buying shoes, the width and length of each foot needs to be measured separately. If one foot is larger than the other, the shoe size should correspond to the size of the larger foot. A one-inch gap between the big toe and the tip of the shoe allows enough space for movement. Even more room is needed with pointed-toe shoes. Shoes should be comfortable from the first wearing -- no breaking-in period should be necessary.

People who wear high heels are also at risk of developing bunions. Heels about one inch in height are best. However, if higher heels are preferred, open-toe styles seem to cause fewer problems than closed-toe styles.



This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.