Introduction
Bunions are a common foot deformity, particularly in women. They often develop due to wearing shoes that are too small or have high heels. The abnormal pressure from poorly fitting shoes can cause the bones in the big toe and foot to shift out of their normal position, resulting in a painful bump on the side of the foot near the big toe.
In some cases, switching to wider shoes with lower heels can alleviate bunion discomfort. However, if non-surgical treatments are ineffective, surgery may be required to restore normal alignment and pain-free movement. Numerous surgical techniques exist for bunion correction, and most individuals achieve positive outcomes.
Anatomy
The base of the bone in your big toe (proximal phalanx) connects with the head of the metatarsal bone in your foot to form the metatarsophalangeal joint. Ligaments hold these bones together, while tendons attach muscles to the bones, facilitating movement. This joint flexes with each step you take.
Causes
Bunions are prevalent, especially among women, although they can also occur in men. Most bunions arise from the pressure of shoes that are too small, narrow, pointed, or high-heeled. Genetic factors can play a role, as bunions may run in families. Conditions like arthritis, particularly osteoarthritis, and polio can also contribute to their development.
A bunion forms when the bones at the base of the big toe become misaligned, causing the big toe to lean towards or even underneath the second toe. This misalignment can also affect the second toe, leading it to overlap the third toe. Chronic irritation can cause the base of the big toe to enlarge, potentially forming a fluid-filled sac, which results in a noticeable bump on the foot's side at the joint.
Symptoms
A bunion creates a noticeable bump on the side of your foot at the base of the big toe, which may appear large, red, swollen, and painful. The skin on the underside of your foot may thicken, leading to painful calluses. Bending your toe, walking, or wearing shoes can be uncomfortable.
The appearance of your foot may change as the big toe leans towards the second toe, causing the first few toes to shift and overlap.
Diagnosis
A bunion diagnosis typically involves your doctor reviewing your medical history, examining your foot, and taking X-rays. These X-rays will reveal the alignment and condition of the bones. It’s important to share your symptoms and any concerns with your doctor.
Treatment
For some bunions, simply changing footwear can be effective. Wearing wide-toed shoes with low heels is recommended. Proper foot care, along with felt or foam pads placed between the toes or on the foot, can help protect the affected area and reduce discomfort. Custom-made shoe inserts may also be beneficial in repositioning the toe and alleviating pain.
Surgery
If conservative treatments are unsuccessful, surgery may be needed to restore proper alignment and function. Bunion surgery aims to realign the bones, joints, tendons, ligaments, and nerves, correcting the position of the toes and removing the bony bump. Various surgical techniques are available, and your doctor will discuss the best option for you.
Bunion surgery is typically performed on an outpatient basis, using either ankle-block or general anesthesia to prevent pain during the procedure. After surgery, the bones are stabilized using wires, screws, plates, or casts while they heal.
Recovery
Post-surgery, it's advisable to keep your foot elevated for the first few days and apply ice packs as directed. A specialized cast or orthopedic shoe will protect your foot during the healing process. Initially, you may need to use crutches, a walker, or a cane as you gradually increase weight on your foot. Physical therapy can aid in restoring strength and mobility. Recovery from bunion surgery can take several weeks, but most individuals achieve satisfactory results.
Prevention
To prevent bunions, it's essential to wear properly fitting shoes. Opting for wide, low-heeled footwear is beneficial. After bunion surgery, continuing to wear similar shoes can help prevent recurrence. Improper footwear can lead to the development of new bunions.
