The foot is made up of many small bones that sit perfectly together forming many joints. The big toe joint comprises of the first metatarsal and the proximal (close) phalanx of the toe. A bunion forms when base of the toe (first metatarsal) drifts away from the second metatarsal. The 1st metatarsal rotates and drops and so no longer sits in its correct alignment. The tip of the first toe then rotates and drifts inwards. Overtime, under the continuing stress of this altered position of the joint and the irritation that this causes, the joint can become inflamed.
Bunions form when the normal balance of forces exerted on the joints and tendons of your feet are disrupted. This can lead to instability in the big toe joint - also known as the first metatarsophalangeal (MTP) joint, causing a deformity. Bunions develop over years of abnormal motion and pressure on your big toe joint. They often result from a combination of your inherited foot type, faulty foot mechanics that affect the way you walk and shoes that fit improperly. Other causes of bunions include foot injuries. Deformities present at birth (congenital). Neuromuscular disorders, such as cerebral palsy or post- polio syndrome (post-poliomyelitis). Bunions may be associated with various forms of arthritis, including inflammatory or degenerative, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet also can be a cause. Waiters, factory workers, dancers and athletes often are more prone to developing bunions.
SymptomsRed, thickened skin along the inside edge of the big toe. A bony bump at this site. Pain over the joint, which pressure from shoes makes worse. Big toe turned toward the other toes and may cross over the second toe.
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
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 or splinting. 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 IB, others) or naproxen (Aleve) can help you 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, although others may require prescription orthotic devices. Applying ice. Icing your bunion after you've been on your feet too long can help relieve soreness and inflammation.
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities, it?s time to discuss surgical options with a foot and ankle surgeon. Together you can decide if surgery is best for you. A variety of surgical procedures is available to treat bunions. The procedures are designed to remove the ?bump? of bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
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