Bunions


A bunion is an enlargement of the joint at the base of the big toe which appears to stick out. The outside of the foot at the base of the little toe can also be affected and is called a tailor’s bunion. A bunion involves enlargement and repositioning of joints at the ball of the foot and most commonly affects women. Tight-fitting shoes, especially high-heeled and narrow-toed shoes, might increase the risk for bunion formation. It also has been suggested that inherited factors may predispose to the development of bunions.

A condition that is often part of the bunion is an abnormal position of the big toe or the bone to which it connects. One such condition is a malformation in which the joint at the base of the big toe bulges outward (medically termed hallux valgus deformity) from the inner side of the foot and the big toe points inward (toward the smaller toes). Excessive turning in of the ankles and injury may also be factors causing bunions. Osteoarthritis may develop and cause joint scarring, limiting the foot's range of movement.

Symptoms and Diagnosis

Symptoms may or may not be present when you have bunion. The first symptom may only be a painless bulge of the joint or pain at the joint when wearing certain shoes. The enlarged joint at the base of the big toe can become inflamed, causing symptoms of redness, tenderness, and pain. A small fluid-filled sac (bursa) next to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. Joint motion may be restricted.

Doctors usually base the diagnosis on symptoms and examination findings. Sometimes X-rays are taken to determine the integrity of the joints of the foot and to screen for arthritis or gout that may be underlying conditions.

Treatment

There is currently no strong evidence pointing to the best treatment for bunions, but in most cases, you can treat them at home.

  • The avoidance of tight, narrow or high-heeled shoes that put pressure on the big toe joint seems appropriate. Wearing wider shoes may significantly decrease discomfort. The use of felt or foam padding on the foot may help protect the bunion from irritation. Depending on the structure of the foot, custom insoles might add further support and repositioning.
  • Stretching exercises can sometimes reduce tension on the inner part of the joint of a bunion.
  • Taking anti-inflammatory drugs or injecting a corticosteroid can help relieve pain and swelling.
  • The surgical removal of the bunion for those whose bunions cause persisting pain can be considered.

Prevention

The prevention consists in avoiding the compression of the toes with narrow, poor-fitting shoes.

When to consult a doctor

If the bunion:

  • Continues to cause pain even after self care, such as wearing wide-toed shoes
  • Prevents you from doing your usual activities
  • Has any signs of infection (like redness or swelling), especially if you have diabetes.

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