Working With Bunions

Overview
A bunion (also called Hallux Valgus) is a painful swelling caused by deformity of the big toe. As this swelling is caused by a bone it can be very unforgiving in shoes, which can rub on it causing pain, particularly formal foot shoes or high heels. Arthritis, or wearing tight or ill-fitting shoes over a period of many years, may increase the risk of bunions. However, they can have other causes. Bunions are more common in women and sometimes run in families.

Causes
You are usually born with a foot type that leads to bunion formation. Flat feet with increased flexibility are most likely to form bunions. Abnormal mechanics increase the bunion formation over time. Other causes of bunions include osteoarthritis, gout, rheumatoid arthritis, trauma, and neurovascular disease.

Symptoms
The major symptom of bunions is a hard bump on the outside edge of the foot or at the base of the big toe. Redness, pain and swelling surrounding or at the MTP joint can also occur.

Diagnosis
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.

Non Surgical Treatment
Follow the advice given by a Podiatrist. Use felt pads to help keep pressure off the painful area of the bunions. Wear shoes that are wide and deep to accomodate the bunions. Fitting of footwear is very important. Avoid the use of high heel shoes. Use exercises to keep the joint mobile. Night splints may help with the bunion symptoms. The aim of these are to hold the toe in a more correct position. Padding or foam between the big toe and the second toe is sometimes recommended, it should, generally, not be recommended as the big toe is usually so strong it just further 'squeezes' the lesser toes and can lead to problems between these toes. The padding between the two toes will not straighten the big toe. However, sometimes the padding may be needed to help with symptoms that originate inside the joint if the bunion is painful.

Surgical Treatment
Some sufferers choose to have the bunion surgically removed. This should always be a last resort as all surgeries carry risks. There are several types of surgical procedures to remove bunions and before deciding, you should speak to your surgeon at length about the facts and risks associated with surgery, including the recovery time and success rate of the operation to be done. Please note that if you have a surgical procedure and then return to your high heels and narrow-toed shoes, the bunion is likely to reoccur.

Prevention
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.