Bunion - Big Toe Joint Deformity
Bunion is an uncharacteristic bony lump that forms base of the big toe, right on the joint. It causes the big toe to become enlarged and forces it to push against other toes, multiplying the discomfort. This pressure also pushes the joint of the big toe outward beyond the normal, causing pain and bunion deformity.
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 Foot bunions are formed when the regular ‘balance’ of pressure that the foot’s joints and tendons are normally subjected to is disrupted. This abnormal pressure causes instability in the joint of the big toe (also called the first metatarsophalangeal or MTP), and eventually causes the deformity.
Bunion Signs and Symptoms
Bunion abnormality first manifests in the form of abnormal bulges on the inside of the base of the big toe. Around the same time, that area may swell, redden and become sore.
Other symptoms of bunion include thickening of the skin at the big toe’s base, corns and calluses (which primarily develop when the first and second toes overlap), and difficulty in moving the big toe. While bunions are generally not incapacitating, it can make walking even in normal shoes very painful.
Bunion Causes and risk factors
Bunions are attributable to many reasons. They are usually a result of three causes: problems with foot type (usually inherited), flawed foot mechanics that affect walking patterns, and shoes that are too tight.
Bunions may also be a result of foot injuries , congenital deformities, or neuromuscular disorders such as post-poliomyelitis and cerebral palsy. Bunion of the foot may also be caused by arthritis that contributes to the deterioration of the protective cartilage covering the big toe joint.
Some people whose occupations require them to be on their feet all day (such as waiters, athletes, etc) are also generally more prone to developing bunions.
Tests and Diagnosis
Physical examination is usually all that is needed to identify a bunion. The doctor may ask the patient to move his big toe up and down to evaluate his range of motion. In some cases, the doctor may require an x-ray of the injured foot in order to determine how severe the problem is.
The doctor also usually asks questions on the types of shoes the patient wears and how frequently they are worn. Most doctors also ask if there is any family history of foot bunions and past foot injuries.
Bunion Treatment
Treatments vary depending on the acuteness of the bunion and the degree of pain it causes the patient. It is best diagnosed and treated during its early stages, when deformities have not yet formed.
Simple, nonsurgical treatments such as wearing comfortable shoes, using padding and taping to reduce pain, using shoe inserts, taking medications such as Acetaminophen and nonsteroidal anti-inflammatory drugs (with the doctor’s prescription), and slight physical therapy can all help heal bunions.
When these non-invasive treatments fail, the patient may be required to undergo surgery. The most common type of bunion surgery is called the ‘bunionectomy,’ which removes the swollen tissue from the joint of the big toe, straightens the big toe by eliminating part of the bone, and permanently joins the bones of the affected joint.
Because it is risky, surgery is not recommendable unless the bunion causes unbearable discomfort. When surgery fails, the patient may still feel pain and even develop a new foot bunion.
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