Overview
When your big toe is angled towards the second toe, the deformity is called a bunion (hallux valgus). This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. Sometimes a fluid-filled sac (bursa) develops over the joint.
Causes
Abnormality in foot function, particularly a pronated foot. This is probably the most important and common causative factor. Family history of bunions. Narrow toed dress shoes and high heels may contribute to the formation of a bunion. Rheumatoid and Psoriatic arthritis. Genetic and neuromuscular disease (eg. Down's,Ehler-Danlos and Marfan's syndromes) resulting in muscle imbalance. Limb length inequality can cause a bunion on the longer limb. Generalized laxity of the ligaments. Trauma to or surgery on the soft tissue structures around the great toe (first metatarsal-phalangeal) joint.
Symptoms
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.
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
Technically, you can only ?fix a bunion? with surgery, but many patients don't need it to get symptom relief. In its early stages, the progression of the bunion deformity can often be dramatically slowed. Removing pressure from the bunion area and balancing the tendon and ligament alignment are the primary goals of mild bunion treatment. For example, it is important to wear shoes that have sufficient room in the toe area to accommodate the bunion - that means softer leather shoes to mold to the deformity and platform type heels for better foot and arch support. Your doctor may also advise the use of pads to protect the bunion from shoe pressure. Customized shoe inserts, called orthotics are made exclusively for your foot and are often used to correct the alignment of the arch and big toe joint. In some cases, physicians also use anti-inflammatory creams around the bunion.
Surgical Treatment
As mentioned above, with mild cases, the bone is cut close to the big toe joint and shifted over into a correct position. The cut bone is held in placed with one or two surgical screws. With this procedure, just the top of the bone is moved over and the bottom of the bone remains in the same place. This technique is called the Austin bunionectomy and refers to type of bone cut that will be made by the Surgeon. There is, however, a limit on how far one can move the bone over with this technique. Its is generally thought that the cut bone should only be moved over a distance equal to half the width of the bone. In somes the bone may be moved over further.
Prevention
If these exercises cause pain, don't overdo them. Go as far as you can without causing pain that persists. This first exercise should not cause pain, but is great for stimulating blood and lymphatic circulation. Do it as often as you can every day. Only do this exercise after confirming it is OK with your doctor. Lie on your back and lift up your legs above you. Wiggle your toes and feet. Eventually you may be able to rapidly shake your feet for a minute at a time. Use your fingers to pull your big toe into proper alignment. Stretch your big toe and the rest of your toes. Curl them under for 10 seconds, then relax and let them point straight ahead for 10 seconds. Repeat several times. Do this at least once a day, and preferably several times. Flex your toes by pressing them against the floor or a wall until they are bent back. Hold them for 10 seconds, then release. Repeat several times. Grip with your toes. Practice picking up an article of clothing with your toes, dropping it, and then picking it up again. Warm water. Soak your feet for 20 minutes in a bowl of warm water. Try doing the foot exercises while soaking, and also relax and rest your feet. Epsom salts. Add it to your warm foot bath soak.
When your big toe is angled towards the second toe, the deformity is called a bunion (hallux valgus). This causes a bump on the side at the base of the big toe. In addition there is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. Sometimes a fluid-filled sac (bursa) develops over the joint.
Causes
Abnormality in foot function, particularly a pronated foot. This is probably the most important and common causative factor. Family history of bunions. Narrow toed dress shoes and high heels may contribute to the formation of a bunion. Rheumatoid and Psoriatic arthritis. Genetic and neuromuscular disease (eg. Down's,Ehler-Danlos and Marfan's syndromes) resulting in muscle imbalance. Limb length inequality can cause a bunion on the longer limb. Generalized laxity of the ligaments. Trauma to or surgery on the soft tissue structures around the great toe (first metatarsal-phalangeal) joint.
Symptoms
If you have a bunion, you may have pain or stiffness of your big toe joint, swelling of your big toe joint, difficulty walking, difficulty finding shoes that fit. These symptoms may be caused by conditions other than bunions, but if you have any of these symptoms, see your doctor.
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
Technically, you can only ?fix a bunion? with surgery, but many patients don't need it to get symptom relief. In its early stages, the progression of the bunion deformity can often be dramatically slowed. Removing pressure from the bunion area and balancing the tendon and ligament alignment are the primary goals of mild bunion treatment. For example, it is important to wear shoes that have sufficient room in the toe area to accommodate the bunion - that means softer leather shoes to mold to the deformity and platform type heels for better foot and arch support. Your doctor may also advise the use of pads to protect the bunion from shoe pressure. Customized shoe inserts, called orthotics are made exclusively for your foot and are often used to correct the alignment of the arch and big toe joint. In some cases, physicians also use anti-inflammatory creams around the bunion.
Surgical Treatment
As mentioned above, with mild cases, the bone is cut close to the big toe joint and shifted over into a correct position. The cut bone is held in placed with one or two surgical screws. With this procedure, just the top of the bone is moved over and the bottom of the bone remains in the same place. This technique is called the Austin bunionectomy and refers to type of bone cut that will be made by the Surgeon. There is, however, a limit on how far one can move the bone over with this technique. Its is generally thought that the cut bone should only be moved over a distance equal to half the width of the bone. In somes the bone may be moved over further.
Prevention
If these exercises cause pain, don't overdo them. Go as far as you can without causing pain that persists. This first exercise should not cause pain, but is great for stimulating blood and lymphatic circulation. Do it as often as you can every day. Only do this exercise after confirming it is OK with your doctor. Lie on your back and lift up your legs above you. Wiggle your toes and feet. Eventually you may be able to rapidly shake your feet for a minute at a time. Use your fingers to pull your big toe into proper alignment. Stretch your big toe and the rest of your toes. Curl them under for 10 seconds, then relax and let them point straight ahead for 10 seconds. Repeat several times. Do this at least once a day, and preferably several times. Flex your toes by pressing them against the floor or a wall until they are bent back. Hold them for 10 seconds, then release. Repeat several times. Grip with your toes. Practice picking up an article of clothing with your toes, dropping it, and then picking it up again. Warm water. Soak your feet for 20 minutes in a bowl of warm water. Try doing the foot exercises while soaking, and also relax and rest your feet. Epsom salts. Add it to your warm foot bath soak.