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If you’ve ever had a bunion, you know that it’s more than just a cosmetic issue. It can be a major source of pain and discomfort that affects your ability to enjoy normal daily activities. Whether they run in your family or they’re a sign that you have an affinity for stiletto heels, bunions shouldn’t be ignored, as they can directly affect the health of your feet as well as the rest of your body.
What Are Bunions?
A bunion—also known as hallux valgus or hallux abducto valgus—is a bony bump at the base of the big toe joint that occurs when the big toe pushes against the second toe, which causes the joint to stick out. Both adolescents and adults can be affected by bunions, although it’s more common in women than men. While some people experience little to no pain from bunions, they can cause significant swelling and discomfort in most depending on the severity of the deformity.
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Bunion Causes, Types and Risk Factors
Bunions can be caused by conditions that are both preventable and unpreventable, such as:
- Wearing high-heeled or narrow shoes
- Uneven weight bearing in the affected foot or tendon
- Foot injuries
- Rheumatoid arthritis
- Nerve and muscle disorders, such as polio
- Congenital defects
In addition to gender, a recent medical study found that bunions are also more common in African Americans, the elderly, those with flat feet, and people who suffer from knee and/or hip osteoarthritis.
The study also found that subjects with a higher BMI actually have a lower chance of developing bunions than those with a normal BMI, prompting the researchers to say that “genetics and improper shoe wear should be explored as risk factors for hallux valgus among those with normal body weight.”
Less common forms of the condition include adolescent bunions and tailor’s bunions. Adolescent bunions, which affect young girls between the ages of 10 and 15, are often due to genetics. And although it’s less common, some people can develop smaller bunions on the other side of the foot at the base of the little toe called tailor’s bunions or bunionettes. The causes, symptoms and treatment of these smaller bunions are nearly identical to the larger ones. Its unique name was created centuries ago when tailors used to sit cross-legged all day with the outside of their feet rubbing on the ground.
As mentioned earlier, you may be one of the lucky ones who don’t experience any painful symptoms with bunions. But if you do experience any of the following signs, it’s probably time to visit the podiatrist:
- Bump at the base of affected toe
- Chronic pain and soreness
- Joint stiffness and instability
- Blisters, corns, and/or calluses on affected foot
- Difficulty walking
EXERCISE YOUR TOES WITH TOWEL CURLS
You should feel this exercise at the top of your foot and your toes.
Days per week: Daily
Main muscles worked: Plantar flexors
Equipment needed: Hand towel
- Sit with both feet flat and place a small towel on the floor in front of you.
- Grab the center of the towel with your toes and curl the towel toward you.
- Relax and repeat.
Tip: You can make this exercise more challenging by placing a weight on the edge of the towel.
Bunions can also lead to other painful foot conditions, such as:
- Hammertoe: A deformity that causes the second, third or fourth toe to bend downward into a position resembling a hammer.
- Bursitis: A condition that causes the bursa—fluid-filled sacs that cushion the joints—in the Achilles tendon and/or heel bone to become inflamed.
- Metatarsalgia: Inflammation and pain in the ball of the foot due to chronic stress and/or abnormal weight distribution in the foot.
Diagnosis and Treatment
Your doctor can often diagnose a bunion immediately after examining your foot but will sometimes use x-rays to determine the bunion’s severity and the proper treatment plan.
Doctors will initially attempt to heal the bunion and alleviate symptoms with one or more of the following non-surgical options:
- Changing footwear to relive tension on the big toe joint
- Ice to reduce pain and swelling
- Medication, such as NSAIDs, to reduce pain and swelling
- Cortisone injections to decrease inflammation
- Padding, taping, or splinting to realign the toes
- Orthotics to provide arch support and realign the toes
- Toe and foot exercises to stretch the muscles and ligaments in the feet (see sidebar)
If none of the treatments above work well enough to relieve your symptoms, surgery is also an option. It’s important to keep in mind, however, that with bunion surgery, there’s an increased risk of complications, such as infection, along with a recovery period that could take as long as six months.
If you’re a good candidate for bunion surgery, your doctor may recommend one or more of the following procedures:
- Tendon and ligament repair to shorten weak joint tissues and lengthen the toe.
- Osteotomy to realign the affected joint with pins, screws, and/or plates.
- Arthrodesis to remove the affected joint surface. This procedure is mostly reserved for severe cases.
- Exostectomy to surgically remove the bump on the toe joint.
- Resection arthroplasty to remove the damaged portion of the joint to provide more space between the toe bones. This is also reserved for severe cases, as well as elderly patients and those with severe arthritis.
Surgery isn’t normally recommended for adolescents since their feet are still growing and there’s an increased chance that the bunions could reappear.
The best way to avoid developing bunions in the first place is to wear properly fitted shoes with a wide toe box, especially when standing and/or walking for prolonged periods of time. Shoes that cause squeezing, cramping, pressure, or irritation can cause bunions to form over time. Shoes with heels that are above 2 inches or have pointy toes should also be avoided.
It’s also important to keep your toes and feet strong with exercise but be sure to report any foot injuries to your doctor as soon as they occur to avoid complications in the future. You should also report any physical changes to your feet overtime.
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