Bunions

What are bunions?

A bunion is an enlargement of the joint at the base of the big toe — the metatarsophalangeal (MTP) joint. The MTP joint has a protective sac (or bursa) that allows for smooth movement. When this joint is damaged or injured, it can cause a bony bump near the base of the big toe.

Bunions will gradually worsen, making it difficult to walk or wear shoes. Bunions can affect anyone, but women are more likely to get them than men. Women often wear narrow shoes that squeeze their toes together, which increases their risk of developing, aggravating, and causing painful bunion symptoms.

A bunion in its advanced stages can significantly change the appearance of your foot. Below are a few of the changes.

• Severe bunions may cause the big toe to overhang or underhang the second toe.
• The toes may rub against one another, causing calluses and additional discomfort.
• The large toe can cause the second toe to contact the third toe due to pressure from the big toe.

What causes bunions?

Bunions are the most common foot deformity, affecting up to 30% of the population at some point in their lifetime. There are many factors known to cause bunions. These include:

• Wearing high heels or tight shoes: When you wear high heels, your body tilts forward. This makes the front of your shoe press against your toes. Your toes can rub against each other in tight shoes, causing your toes to crowd in the front of the shoe.
• Hereditary: Bunions can run in the familty, as some foot types are more prone to bunions than others. Low arches, flat feet, and loose joints or tendons increase your risk.
• Underlying conditions: Inflammatory medical conditions like rheumatoid arthritis increase your risk of bunions.
• Other causes and risks include: Injuries, obesity, gait imbalance and birth deformities.

What are the symptoms of bunions?

The symptoms of bunions include:

• Swelling
• On-going pain
• Tenderness and pain
• Numbness in the big toe
• Shoes are difficult to wear
• Inflammation and redness
• A stiff and restricted big toe
• Calluses and corns on bumps
• Intensive hardening of the skin on the bottom of the foot

How are bunions diagnosed?

Dr. Hassan can identify bunions by carefully examining your foot and making a diagnosis based on your symptoms and toe appearance. He will order an x-ray if necessary to confirm the diagnosis.

How are bunions treated?

In many cases, conservative treatments like changing shoes, icing the joint, and taking over-the-counter pain relievers can relieve symptoms. If these methods do not work, Dr. Hassan may recommend other bunion treatments like custom shoe inserts or pads to reduce friction on the big toe joint.

In some cases, surgery may be necessary to correct the deformity. There are many different types of bunion surgery, and Dr. Hassan will recommend the best procedure for your individual case.

Non-Surgical Treatments:

Non-surgical treatments can help reduce pain and slow the progression, but they cann't reverse the condition.

• Changes in Footwear: Bunions can be treated with shoes that fit correctly and do not compress the toes. You can change specific shoes by stretching the pressure points using a stretcher. Dr. Hassan can determine the type of shoes you should wear and how they should fit.
• Padding: You can use a bunion shield or pad to soften the painful areas around the bunion. However, if the pads are large, you may feel more pressure on the bump after a short time. This could aggravate the pain instead of reducing it.
• Custom Orthotics: Dr. Hassan may recommend wearing custom-made orthotics to relieve pressure on your bunion. You can also use toe spacers. Some people find comfort in a splint that puts their big toe in a straight position during the night.
• Icing: You can use ice for 20 minutes several times a day. Ice can effectively reduce swelling. However, avoid applying ice directly to the skin.
• Medications: Ibuprofen and naproxen are anti-inflammatory medications that can reduce swelling and relieve pain. Bunions caused by arthritis can be controlled by using other drugs.

Surgical Treatments

Dr. Hassan may recommend surgery to restore the toe to its normal position if non-surgical measures do not relieve your pain and you continue to experience debilitating pain. Bunion surgery realigns bones, tendons, ligaments, and nerves to restore the big toe to its proper position. Several surgical treatments are available:

• Arthrodesis: The big toe joint is removed, and the bones are fused together. This procedure is used when the bunion is severe and other methods have failed.
• Osteotomy: The big toe joint is cut to allow the bones to be realigned. A small metal pin or screw may be used to hold the bone in place during healing.
• Exostectomy: The bunion is removed, and the big toe joint is repaired.
• Ligament or Tendon Release: Dr. Hassan will loosen or remove the tendons or ligaments around your big toe to allow it to be positioned correctly.
• Arthroplasty: The damaged cartilage surface of the big toe joint is removed, and a plastic or metal joint replacement is inserted.

After surgery, you will need to wear a splint or cast for four to six weeks. You will probably be able to walk on your foot after a few days, but you may need crutches. Physical therapy may also be recommended to help reduce pain and swelling.

How can I prevent bunions?

There are some steps you can take to prevent bunions or at least slow their progression:

• Proper footwear is essential for preventing bunions and preventing them from getting worse.
• If your feet flatten excessively, wear supportive shoes. Dr. Hassan can prescribe custom orthotics.
• Orthotics can help prevent bunions or slow their progression in people with inherited structural foot problems.

What are the possible complications of bunions?

Bunions may cause complications such as:

• Osteoarthritis: This happens when there is a major change in a joint.
• Bursitis: A painful form of arthritis occurs when the tiny fluid-filled pads surrounding your joints swell.
• Hammertoe: When the middle joint of a toe bends abnormally, usually beside your big toe, it can cause pressure and pain.
• Metatarsalgia: This condition causes swelling and pain in the ball of the foot.
• Bone Spurs: This condition occurs when smooth, bony growths form near the joints.