What Is a Bunion and Who Develops Them?

When you have a bunion, it looks like the joint at the base of the big toe has bulged out along the side of the foot. In that characteristic “bump,” you are actually seeing the effect of additional bone formation in the joint and a mechanical mis-alignment of the big toe (also called the great toe). A bunion causes the big toe to angle toward the smaller toes. This abnormal, and often painful, position is referred to as hallux valgus or hallux abducto valgus.

Although bunions affect women much more often than men, tight-fitting and high-heeled shoes are not the sole cause of bunions. Ill-fitting shoes may add to the problem, but some inherited factors may predispose certain people to the formation of bunions, including congenital abnormalities in bone formation, rheumatoid arthritis, nerve conditions and injury.

What Are the Symptoms of a Bunion?

Sometimes bunions cause no symptoms whatsoever, but most bunions cause intermittent (comes and goes) or chronic (persistent) pain at the base of the big toe. The pain may be worse when walking or wearing shoes, and it may feel better when resting. Very painful bunions may appear red and swollen, and feel tender to the touch.

In order to diagnose you properly, your doctor will consider your symptoms, examine your feet, and take X-rays to get a clear view of the alignment of your toes and the condition of the joints in your feet.

How Are Bunions Treated?

Your doctor may recommend different treatment options depending on your particular injury and symptoms.

Rest Up and Dress Right.
Resting your feet more often can go a long way toward alleviating the irritating pain of a bunion. Make sure the shoes you wear have a roomy toe box and a low heel so not to crowd the toes. Remember, well-fitting shoes will be comfortable from the start.

Manage the Pain.
Your doctor may prescribe or recommend the use of anti-inflammatory medications (like aspirin or ibuprofen) and cold packs that will help to reduce inflammation as well as the pain associated with your bunion. Sometimes a local injection of cortisone at the base of the big toe helps to further reduce inflammation.

Get the Right Support.
Orthotic devices sometimes help. A bunion splint worn at night or custom-made shoe insoles provide support, and may have the added benefit of helping to reposition the mis-aligned joint.

Understand Your Surgical Options.
If you are still experiencing bunion pain after all other conservative measures have been taken, your doctor may suggest surgery to help relieve your pain and restore your mobility. Bunion surgery often involves removing the unwanted bony growth and re-aligning the big toe. Today, a full range of surgical solutions are available that enable your doctor to customize the procedure to your particular needs and anatomy – whether you need joint support or surgery.

Be sure to talk with your doctor about the best treatment option for you.


HAMMERTOES & CORNS

Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.

Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.

A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.

In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.

If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.