A bunion is an overgrowth of the bone at the origin of the big toe. This commonly occurs in conjunction with misalignment of the big toe. The big toe is bent towards the other toes. This condition is medically termed as hallux valgus deformity. There is inflammation, redness and pain at the first MTP joint of the big toe. The bursa close to the joint may also become inflamed resulting in bursitis. Sometimes the smallest toe may also be affected. This condition is called tailor's bunion.
Bunions are the overgrowth and repositioning of the joint of the toes. Bunions usually affect the inner side of the foot, but the outer side of the foot can also be affected such as the base of the little toe. Women are more commonly affected than men. Sometimes bunions can be asymptomatic. They can be treated with rest, change of footwear, foot supports, medications, and surgery if required.
Symptoms of Bunions or Hallux Valgus Deformity
- Pain when walking or wearing footwear.
- Sometimes, patients do not have any symptoms.
- Pain is felt around the ball of the big toe due to rubbing of the bone on the shoes.
- The base of the big toe is enlarged and the big toe is bent inwards towards the other smaller toes.
- Swelling, redness, local tenderness may also be present.
Causes of Bunions or Hallux Valgus Deformity
The exact cause for development of bunions is not known, but some factors which increase the risk are:
- Excessive pronation.
- Wearing tight and high heeled shoes.
- Ageing increases the risk of developing bunions due to decrease in strength of ligaments with age.
- Hereditary factors also increase the risk.
Treatment of Bunions or Hallux Valgus Deformity
- Resting the foot.
- Avoiding aggravating activities such as walking.
- Wearing proper fitting shoes.
- The big toe should be separated from the next toe with the help of a bunion splint or a 1 cm thick piece of foam.
- A hole can be made in the padding to protect the bunion.
- Patient should consult a sports injury specialist or a podiatrist who can make orthotic devices for the foot.
- Anti-inflammatory medications such as aspirin, naproxen help in pain and inflammation.
- Cortisone injections help in relieving inflammation.
- Antibiotics are needed if there is any infection.
- In severe cases, bunion surgery may be required to realign the joint.
Surgical Treatment of Bunions or Hallux Valgus Deformity
- A bunion is an overgrowth of the joint between the foot and the big toe. The big toe appears bent towards the other toes. Surgery is done in severe cases where walking is extremely painful and where other treatments such as padding, bunion splint and orthotics do not help.
- Bunion surgery comprises of realigning the joint into its normal position. Surgery is performed under general anesthesia and is usually an outpatient procedure and does not require an overnight stay in the hospital.
- The surgeon makes a cut on the internal side of the big toe joint or the first MTP joint and trims the excess bone. The ligaments and tendons are also repositioned. Screws or wires are used to fix the joint. These may be dissolvable or can be removed at a later date or in some cases, may be left in the foot.
- After the surgery, the foot is immobilized in a cast in order to stabilize the bones in alignment for about 5-7 weeks. Crutches should be used to avoid complete weight bearing. After this period, the doctor checks the foot to assure that the bone has healed properly. After complete healing, full weight bearing can be gradually started.