A bunion forms when the bursa (a sac of fluid at friction points between the tendons and bone in some areas and between bone and the skin in others) becomes inflamed along the edge of the joint at the base of the big toe. There are two types of bunions. The acute bunion causes the sharper pain. It develops from a bursitis, a sudden outcropping of a fluid-filled sac. An acute bunion can progress into the second type of bunion, the hallux valgus, a chronic but often painless deformity involving permanent rigidity of the bones. Bunions can form in any part of the foot but occur most often at the big toe joint, where the first metatarsal bone abuts the proximal phalanx of the big toe. Women are more likely than men to get bunions because of the misshapen footwear and elevated heels they wear.
Foot problems typically develop in early adulthood and get worse as the foot spreads with aging. For many people, bunions run in the family. They may be just one of several problems due to weak or poor foot structure. Bunions sometimes develop with arthritis. In people with leg length discrepancies, bunions usually form in the longer leg. Women are especially prone to developing bunions. Years of wearing tight, poorly fitting shoes especially high-heeled, pointed shoes can bring on bunions. Such shoes gradually push the foot bones into an unnatural shape.
SymptomsBunions are an often painful condition that may become even more painful as extra bone and a fluid-filled sac grow at the base of your big toe. Some of the most frequently experienced signs and symptoms associated with bunions, besides pain, include redness in your affected area. Blistering over your bunion. Callus formation around your bunion. Bursitis. Nerve damage (numbness and/or sharp pains) in your involved area. Bunions may also cause pain within and below your first metatarsophalangeal, or MTP, joint. Your bunion may become further dislocated and unstable as it progresses and may overload your adjacent joints.
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.
Non Surgical Treatment
Bunions often respond to conservative care measures and should always be treated by a qualified healthcare professional in a timely and appropriate manner. Conservative treatment for bunions usually involves the following, splinting your great toe (so that it does not migrate toward the inside edge of your foot). A toe-spacer (such as Correct Toes) may be a useful tool, because it helps progressively splay and re-align all of your toes. Performing range of motion exercises (to move your big toe into a more favorable position). Supporting of the joints in the back of your foot that cause forefoot instability. Using shoes that allow the bunion splint to keep your big toe pointing straight ahead.
In severe hallux valgus bunion cases, the first long bone (metatarsal) in the foot dramatically shifts away from the second metatarsal, resulting in looseness and a large deformity. In severe bunion corrections, a surgery known as the Lapidus procedure realigns the first metatarsal into its natural position. Using screws, the surgery holds the bone stable so it does not shift again and reduces the change of the bunion returning to basically none. Surgery may also involve removing the enlarged portion of the bunion region, cutting and realigning the bone, and correcting the position of the tendons and ligaments. By using a special plate with Lapidus procedures, University Foot and Ankle Institute patients are able to put weight on their foot after only 2-3 weeks, rather than the typical 6-8 weeks of no weight.