A bunion is a thickened lump at the base of the big toe. It causes the big toe to move toward the smaller toes and makes walking difficult.
Causes
Bunions are caused by a deformity of the metatarsophalangeal (MTP) joint at the base of the big toe. This causes instability of the joint.
Deformity can be caused by:
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Flat feet, which transfer too much weight to the MTP joint
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Narrow-toed shoes and high heels
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Certain neuromuscular diseases (Down and Marfan syndromes)
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Activities that put undue stress on the feet, such as ballet
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a bunion include:
Symptoms
Symptoms include:
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Big toe that turns in toward the other toes (may overlap second or even third toe)
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Firm bump on the outside edge of the foot or at the base of the big toe
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Restricted or painful motion of the big toe
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Foot pain and stiffness
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Fluid-filled cyst between the skin and the bony lump
Diagnosis
The doctor will examine your foot and ask about your symptoms. An X-ray of your foot will confirm that you have a bunion and show the extent of the damage.
Treatment
The goals of treatment are to relieve pressure on the bunion and stop progression of the deformity.
Padding and Taping
Padding the bunion reduces pain and allows you to continue a normal, active life. Taping helps to keep the foot in a normal position, reducing stress and pain.
Medication
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Anti-inflammatory drugs (ibuprofen, naproxen) to ease pain and inflammation
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Cortisone injections to ease pain and inflammation
Proper Footwear
Wear shoes that are wide and deep in the toe area. Make sure the top of the shoe doesn't hit or rub against the bunion. There should be one-half inch of space between the shoe and the end of your longest toe when you are standing up.
Physical Therapy
Physical therapy can relieve inflammation and pain. Ultrasound therapy is often used for treating bunions and the related soft tissue problems.
Orthotics
Shoe inserts may be useful in maintaining foot function. They are thought to reduce symptoms and prevent worsening of the deformity.
Surgery
Surgery may be needed to relieve the pressure and repair the toe joint, if the other treatments fail. Surgical procedures include:
Prevention
These tips can help to protect your feet and possibly reduce the risk of bunion:
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Exercise daily to keep muscles of the feet in good condition and alignment.
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Wear wide-toed, well-fitting shoes with plenty of room for your toes.
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If you have a bunion and it becomes inflamed, lift your foot above your heart and apply an ice pack over the painful area. Do this for no more than 20 minutes every other hour.
RESOURCES:
American Orthopaedic Foot and Ankle Society
http://www.aofas.org
American Podiatric Medical Association
http://www.apma.org
References:
Complete Home Medical Guide. American College of Physicians; 1999.
National Institute on Aging
