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Bunions

Overview
Bunions
A bunion is a painful deformity of the joint where the bones of the foot and the big toe meet. The enlargement of the bone and tissue around this joint is known as a bunion or hallux valgus. Symptoms of a bunion include a swollen bursal sac, a bony deformity on the side of the great toe joint, tender and swollen tissues surrounding the deformity, and displacement of the big toe, which may turn inward.


Causes
Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arhritis or an injury produces a bunion. And some people are simply born ith extra bone near a toe joint. If you’re at risk for developing a bunion, wearing high-heeled or poorly fitting shoes make the problem worse. As new bone grows, the joint enlarges. This stretches the joint’s outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe farther out of alignment.


Symptoms
The signs and symptoms of a bunion include a bulging bump on the outside of the base of your big toe, swelling, redness or soreness around your big toe joint, Thickening of the skin at the base of your big toe, Corns or calluses, these often develop where the first and second toes overlap, persistent or intermittent pain, restricted movement of your big toe. Although bunions often require no medical treatment, see your doctor or a doctor who specializes in treating foot disorders (podiatrist or orthopedic foot specialist) if you have persistent big toe or foot pain, a visible bump on your big toe joint, decreased movement of your big toe or foot, difficulty finding shoes that fit properly because of a bunion.


Diagnosis
Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight. X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout , rheumatoid arthritis , or joint infection.


Non Surgical Treatment
Separating the big toe and the next one with a 1 cm thick piece of foam can relieve painful symptoms. This can be fixed in place with some zinc oxide plaster tape and has the effect of straightening the great toe and relieving pressure on the bunion. A taping technique will support the joint and relieve the pressure on the inside of the foot. Off the shelf orthotic insoles can be worn to help correct any biomechanical problems in the foot which may be causing the problem. If the foot rolls in or over pronates then this causes the arch of the foot to flatten and more pressure is placed on the base of the big toe where the bunion forms. A podiatrist is a therapist who specializes in feet. They can do a full gait analysis and make orthotic inserts to correct biomechanical foot problems. Severe cases may require surgery to realign the joint but this is a last resort if conservative treatment has failed.
Bunions Callous


Surgical Treatment
Procedures can range from shaving off excess bone to restructuring and fusing the big toe. For mild conditions, you may simply need the connective tissues holding your big toe to be tightened so they hold the digit in the correct position. More advanced bunions will need more manipulation and involved remedies. Cuts in the bone tissue can help our specialists realign the toe. You may need to have the damaged portion of the joint removed. In severe cases, the joint may be fused to prevent it from moving out of position again. If your bunion created other foot complications, like hammertoes, our specialists may correct those during the procedure as well.

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