A bunion is a bone deformity caused by an enlargement of the big toe joint (first metatarsalphalangeal joint). Bunions form when the big toe (hallux) moves out of place, deviating laterally, towards the second toe. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the deformity worsens; the bony prominence gets bigger and the big toe overlaps the second toe. If the toe starts to rotate and twist, the deformity is called Hallus Abducto Varus. The pressure of the great toe on the lesser toes can increase the digital deformity such as hammertoes.
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, the joint may become arthritic with cartilage damage internally, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
Wearing shoes that are too tight is a leading cause of bunions. Bunions can be hereditary; they tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet are also causes of this deformity. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
Removal of corns and calluses on the foot.
Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
Exercises to maintain joint mobility and prevent stiffness or arthritis.
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.