Bunions are one of the more serious conditions that can affect foot health. A bunion is actually a bone deformity of the big toe, where the joint at the base and side of the toe is enlarged, forcing the toe out of place. Left untreated, bunions worsen over time. The big toe angles in toward the rest of the toe, and can overlap the third toe (a condition known as Hallux Valgus). Or, it may move toward the second toe and twist or rotate (Hallus Abducto Valgus). Bunions can also lead to deformities like hammertoes. Bunions cause discomfort and pain, because the enlargement constantly rubs against footwear. The skin of the toe becomes red and tender. The larger a bunion grows, the more painful it is to walk. People with bunions can develop thickening skin on the bottom of the foot, bursitis or arthritis, and chronic pain.
Heredity and shoe gear are probably the most likely reason for you to develop a bunion. Bunions occur gradually over time. Tight and/or pointy shoes that crowd the toes may result in a bunion. High heels are also suggested to cause bunions as well. See Causes of Bunions.
Bunions may cause no pain at first. But as the big toe begins to turn in towards the other toes, people with bunions usually experience redness, pain, swelling, and tenderness in the area around the joint. Pressure inside the joint or from footwear pressing against the bunion may also cause discomfort. As the affected toe curves closer to the other toes on the foot, these toes can become painful as well. Complications of bunions include corns, calluses, hammer toe, and ingrown toenails. Other complications include irritation of the nerves surrounding the bunion area. Excess rubbing of the bunion against the footwear may lead to changes in the skin, resulting in corns or calluses. Hammer toe is a deformity of the toe immediately next to the big toe. A hammer toe is slightly raised and points upwards from the base and downwards at the end of the toe. Ingrown toenails can result from increased pressure from the big toe on the other toes. There may also be a decrease in the amount a person can move the joint affected by the bunion. Irritation of the nerves will feel like burning or decreased sensation.
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.
Non Surgical Treatment
When the deformity is mild, treatment is usually not necessary. However, changing shoes to ones that have little or no heel, and are wider in the toe area (toe box) will be more comfortable and may help to prevent worsening of the bunion deformity. If the bunion starts to become painful, other measures may help. Bunions can cause pain in several different areas. The medial eminence may be painful, the entire first toe joint may hurt, or there may be pain underneath some or all of the forefoot (the ball of the foot). Pain over the medial eminence is the most common problem that affects bunion patients. A ?toe spacer? can be placed between the first and second toes and can provide some pain relief as it straightens out the bunion slightly. Pads placed over the medial eminence itself are hard to keep in place and rarely help to relieve pain. Pain underneath the first toe or lesser toes can be relieved by pads placed in the shoes in precise areas. The pads help to take pressure off the prominent areas on the bottom of the foot. Generalized measures to relieve bunion pain, such as physical therapy or foot stretching exercises, have not been shown to be helpful. Orthotics are often prescribed, but are also rarely helpful in relieving pain over the bunion, but may help with pain felt under the ball of the foot.
Surgery may be considered if your symptoms are severe and don't respond to non-surgical treatments. The type of surgery will depend on the level of deformity, the severity of your symptoms, your age, and any other associated medical conditions.