A bunion is generally considered as an enlargement of the joint (a lump of bone) at the base and side of the big toe (specifically, the first metatarsophalangeal joint). Bunions form when the toe moves out of place. As the big toe bends towards the others this lump becomes larger and the bunion can become painful, arthritis and stiffness can eventually develop. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint, most of the time the two go together and can just be referred to as 'bunions'. The word bunion is from the Latin "bunion," meaning enlargement.
Despite the popular belief, wearing high heels and too-narrow shoes does not cause bunions. Wearing them can irritate, aggravate, or accelerate the formation of the bunion, but are not the root cause. Bunions are more commonly inherited, if your parents or grandparents had bunions, you may also get one. Bunions can also be caused by trauma or injury to the joints, ligaments, or bones of the foot.
Symptoms include pain in and around the ball of the big toe, usually from the bone rubbing too much against the shoe. You may be unable to wear certain types of shoes due to the shape of the forefoot. The big toe appears to be bent inwards towards and in come cases over the inside toe.
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
Some bunions can be treated without surgery. If you have a bunion, wear shoes that are roomy enough so that they won?t put pressure on it. You can choose to have your shoes stretched out professionally or try cushioning the painful area with protective pads. Orthotics have been shown to help prevent progression of bunions. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Applying an ice pack several times a day can also help reduce inflammation and pain. If your bunion progresses to a point where you have difficulty walking or experience pain even with accommodative shoes, surgery may be necessary.
Surgery is a last option for those with advanced and painful bunions that do not respond to any other treatment. The surgical operation to correct the deformity from a bunion is called a bunionectomy, which typically involves removing bony growth of the bunion, re-positioning ligaments and tendons, and realigning the bones of the toe joint. Surgery is usually a day procedure performed with a local anaesthetic. The bones may be stabilised in their new position with screws or pins. Hardware may even include absorbable pins that are broken down by the body after a few months. You can expect a 6 - 8 week recovery period during which crutches are usually required. Surgery is often successful but sometimes the big toe moves back to its previous deviated position. Proper footwear and orthotics reduces the chances of surgical failure.