A bunion is a very misunderstood foot deformity. Most people see the prominence on the side of their great toe and assume that this represents a bump or lump on the bone of the great toe. The main purpose of the diagram is to show that the bunion is formed by the angle created by two bones.
It is a very difficult deformity to treat surgically because once the bones start to move it is difficult to halt their progression. The only treatment that can stop a bunion from getting larger and also reduce bunion pain is an orthotic. Orthotics change the position of the feet and reduce how much weight is being transferred to the bunion site.
Not all bunions are painful but if they are painful it is either in the outer aspect which people refer to as the bump or in the joint itself. Many complaints seem to begin after the involvement of court sports. This is basically due to the fact that the lateral motion required in court sport puts pressure on the great toe joint due to the pivotal motion required. Many people seem to have an aching or sharp sensation in the first toe joint after a strenuous game of racquetball or handball.
What are they caused by?
Hallux valgus, also known as bunion deformity, is a condition that affects the joint at the base of the big toe. The bunion actually refers to the bump that grows on the side of the first metatarsophalangeal joint. In reality, the condition is much more complex than a simple bump on the side of the toe. Pointed shoes, such as high heels and cowboy boots, can contribute to the development of hallux valgus, while wider shoes, which provide adequate room for the toes, can decrease the chances of developing the deformity and help reduce the irritation on the bunion.
What do they look and feel like?
The symptoms of hallux valgus usually involve the bunion. The bunion can be painful and may present as a cosmetic problem. Bunions present as bumps on the inside of the big toe joint, with the big toe positioned closer to the second toe and, in severe conditions, the second toe contracted and overriding the big toe. Increasing deformity can cause the second toe to constantly rub on the shoe and create a corn. Finding appropriate shoes can become difficult, especially for women who desire to be fashionable.
How are they treated?
Changing the type of shoes the patient wears to fit the foot. In the early stages of hallux valgus, converting from a pointed toe shoe to a wider box toe shoe may slow the progression of the deformity.
Bunion pads may reduce pressure and rubbing from the shoe. There are also numerous devices, such as toe spacers, that attempt to splint the big toe and reverse the deforming forces, but these are found to have minimal effect on the bunion.
If all conservative measures fail to control the symptoms, then surgery may be suggested by your podiatrist to treat the hallux valgus condition, which may consist of removing the bump, re-aligning the big toe joint, and balancing the forces to prevent return of the bunion.
Credit: University of Texas Health Science Center San Antonio
