Bunions
Definition
Bunion is the misalignment of the big toe joint (Hallux Abducto Valgus) or the first metatarsophalangeal joint. It is a progressive bony degeneration.
Symptoms
The big toe joint protrudes outwards making the forefoot wider. The joint may become red, inflamed, and painful with restrictive footwear. Pain will be relieved once shoes are taken off. Patients may also get inflammation of the bursa which is adjacent to the big toe joint leading to bursitis.
Causes
- Tight restrictive footwear with high heels can increase the risk of developing a bunion
- Genetic predisposition (especially in younger cases)
- Poor biomechanics (flat feet) accompanied by poor shoe selection
- Patients with Rheumatoid arthritis
Who can get bunions?
- People who wear tight/constrictive footwear with high heels
- Ballet dancers
- People with a family history of bunions
- Bunions are more common in women than in men
Risks
If bunions are not attended to in a timely manner, the following may occur, leading to further complications:
- Clawing of lesser toes as the big toe deviates and loses its functionality
- Breakdown of skin at the big toe joint, which may lead to an infection
- Formation of corns and calluses in areas of high friction and pressure
- Big toe over-riding the lesser toes
- Widening of the forefoot
- Difficulty finding appropriate footwear due to forefoot widening
Prevention
- Wear wide supportive shoes
- Avoid tight narrow-fitting shoes. Wearing such shoes can accelerate bunion formation. Wearing supportive shoes with orthotics may slow down bunion growth.
Treatment
- Wear wide supportive shoes for walking
- Use custom-made inner soles (orthotics) to support the arch and big toe joint
- Ice the big toe joint with a cold pack
- Rest
- Take anti-inflammatory medication to reduce inflammation and pain
If conservative measures do not help and the joint remains painful, surgery may be suggested to correct the alignment of the big toe joint. This surgical procedure is called bunionectomy.