Bunions

Causes Of Bunion

Each foot has five bones, known as metatarsal bones, numbered one to five from the hallux (great toe) to the small toe. These bones are connected to the bones of the toes, known as phalanges, through metatarsophalangeal joints (MTP). Numerous bands of tissues and muscles help hold bones and  joints in place. 

The exact cause of bunion is unclear, but it is thought to occur due to a complex interplay of the following factors:

• Imbalance of the muscles of the foot can cause slight misalignment of the toe

• Increased pressure at the first MTP joint

The muscle imbalance and increased pressure at the MTP joint push the greater toe towards the second toe. This increased tension also increases the hallux angle—the angle created between the phalanx (toe bone) and the first metatarsal. These forces strain the ligaments, eventually causing them to rupture. 

These changes are seen as a “bump” at the base of the big toe. Due to increased pressure at the MTP joint, the deformity worsens as the individual walks. 

Symptoms Of Bunion

A bunion is a disorder of the great toe in which it is moved towards the second toe. The onset of this deformity is generally chronic. The signs and symptoms include:

• Bump at the joint of the base of the big toe

• Rotation of the toe

• Bulging of the head of the big toe

• Burning or tingling pain at the metatarsophalangeal joint (joint that joins bones of the foot to the toe)

• Thickening of the skin at the base of the big toe

• Toe tenderness

• Limitation in walking

• Difficulty in wearing shoes

The pain's frequency, duration, and severity increase as the disease progresses.

Interesting fact!

Bunion is derived from the Latin word "bunion," which refers to enlargement.

Types Of Bunion

Large bunion

This involves the presence of a large protruding mass near the big toe joint, which eventually turns the big toe towards the second toe. 

Tailor's bunion (bunionette)

This type of bunion affects the smallest toe. Although this type of bunion is less common, it can be red and painful, especially if it rubs against your shoes.

Adolescent bunion

Adolescent bunions are bunions that occur in young people. They are most common in girls between the ages of 10 and 15. Adolescent bunions generally do not limit motion but are mostly painful. 

It is advised to delay the surgery of such a bunion until skeletal maturity.

Risk Factors For Bunion

The following risk factors can trigger the formation of bunions:

1. Family history

Individuals with a family history of foot problems are more likely to develop bunions. 

2. Foot problems

Individuals with specific foot problems are more likely to develop bunions. The deformities that increase the chances of foot problems are:

• Flat foot (a condition in which the arches on the inside of the feet flatten when pressure is put on them)

• Abnormal and excessive mobility of the first toe

• Excessive foot pronation (rolling of the foot towards the inner side while walking)

3. Gender

Women are more prone to developing bunions, mainly due to the use of high heels. 

High heels can cause pain in your heels, back, and knees. Here are five habits of women that can be harmful to them.
Click to Know

4. Arthritic conditions

People with arthritis have an increased chance of developing foot problems. 

Are you looking for supplements to support your bone, joint, and muscle health?
Buy Now

5. Connective tissue disorders

Connective tissue disorders cause inflammation of the tissues, which may weaken the support of the joint, predisposing the individual to develop bunions. The connective tissue disorders that can cause bunions include Marfan syndrome, Ehlers-Danlos syndrome, and Down syndrome. 

6. Muscle imbalance and postural dysfunction

Disturbed muscle balance and postural dysfunction due to certain medical conditions, such as stroke and cerebral palsy, may lead to the development of bunions. This is because the limited range of motion of the big toes causes bony protrusions. 

7. Types of shoes

People who wear the following types of shoes are more prone to bunions:

• Tight shoes

• Poorly fitted shoes

• Narrow and pointed shoes

• Heels

Here is how wearing the wrong footwear can harm your feet.
Tap to Know

8. Occupation

People in occupations that involve a lot of standing and walking are more susceptible to bunions. Such professions include:

• Teaching

• Nursing

• Ballet dancers

• Athletes

Diagnosis Of Bunion

The doctor gets a thorough medical history along with the knowledge of symptoms. The following steps aid in the diagnosis of bunion:

1. Physical examination

In most cases, bunions can be easily diagnosed through physical examination of the foot. Doctors also move the toe gently to determine whether pain occurs during motion. 

2. X-rays 

It provides images of dense structures such as bone. An X-ray helps to check:

• Alignment of the toes

• Damage to the MTP joint

• Arthritis associated with bunion

3. Ultrasound

It is recommended in severe cases where the person is experiencing numbness and tingling sensation in the feet. It helps to reveal the involvement of nerves.

4. Magnetic resonance imaging (MRI)

Any changes in the foot's structure may lead to other types of damage, such as fracture. This is diagnosed through an MRI scan, which can also reveal any inflammation in the nerves of the feet and toes.

Prevention Of Bunion

1. Choose the right footwear

Choosing the proper footwear can easily prevent most cases of bunions. Before buying footwear, it is advised to check the following parameters:

• Comfort: The pair of shoes should provide instant comfort when the feet are slipped into the feet. There should be no pinching or rubbing-like feeling while wearing shoes. 
• Size: Individuals should make sure that the footwear have proper length and width. Avoid choosing the size by marking, as it may vary according to the style and company. 
• Support: The footwear, especially shoes with an arch support, minimizes the chances of a bunion. 

2. Rest your feet

Proper rest is essential between physical activities that exert a lot of pressure on the feet. It is also advised to take off shoes for a few minutes at regular intervals, which gives your feet room to breathe. 

3. Have your feet measured regularly

The size of our feet changes as we age. Therefore, it is essential to measure the size of our feet regularly and change our footwear accordingly.

Measure the size of both feet. In most people, one foot is larger than the other. Fit shoes to the largest foot.

4. Maintain a healthy weight

Excess body weight puts pressure on the feet, increasing the incidence of foot problems, including bunions. Maintaining a healthy weight can help prevent bunions by reducing pressure on the big toe joint. 

Want to lose weight? Here are 5 effective weight loss tips!
Click to Know

Specialist To Visit

Individuals should immediately consult the doctor in case of the following symptoms:

• Persistent big toe or foot pain

• The presence of a bump on the big toe joint

• Difficulty in wearing shoes

• Difficulty in moving the feet 

The doctors that might help include:

• General Physician

• Podiatrist

• Orthopedic surgeon
  
  

A general physician will examine your symptoms and initiate treatment. They also refer you to some specialty doctors.

A podiatrist treats the feet and their ailments, such as bunions. 

Orthopedic surgeons can be consulted for bunion surgery. 

Consult India’s best doctors online.
Consult Now

Treatment Of Bunion

I. Nonoperative management

1. Changing the shoes: The primary treatment approach involves changing footwear. Individuals with bunions are advised to wear wider shoes with low heels to correct the toe's alignment. 

2. Orthotics: They are shoe or heel inserts designed to reduce pain. Two types of orthotics are available in the market: over-the-counter and custom orthotics. Anyone can use OTC orthotics. Custom orthotics are specially designed according to the size of the sole. 

3. Medical bunion pads: These are the pads that are placed inside the shoe. They act as a cushion and provide protection and support to the foot and ankle. The pads reduce the weight placed on the foot while walking, which helps in reducing the pain. 

4. Splints: A splint is a supportive device that keeps the affected part static. It is readily available and meant to be worn on the foot. It helps alleviate pain and promote healing. 

5. Ankle braces: Ankle braces help limit motion and support the foot and ankle, which can help reduce pain and prevent further injury. They are made of fabric. 

6. Toe spacers: These are separators that keep a definite amount of space between the toe muscles. They help reduce pain and also help perform foot-strengthening exercises.

Buy the support aid for your ankle, foot, and leg.
Shop Now

II. Medications

Anti-inflammatory medications such as paracetamol, ibuprofen, and naproxen may be prescribed to reduce toe pain and swelling. In severe cases of pain, cortisone injections might also be administered.

III. Operative management (Surgery)

Surgery is often recommended if the individual has:

• Persistent pain and difficulty walking even after a change in footwear and other nonsurgical procedures. 

• Chronic big toe inflammation 

• Drifting of the big toe towards the smaller toes 

• Inability to bend and straighten the big toe

The primary aim of the surgery is to reduce pain by adjusting the position of the big toe. 

Several types of surgeries are available for bunions. The surgeries are performed based on the diagnosis made by X-ray and physical findings. 

In most cases, a hospital stay is not required after bunion surgery. However, recovery may take several weeks.

IV. Post operative care

Postoperative care depends on the type of surgery performed. Right after surgery, individuals may be able to bear weight on the foot using a stiff-soled shoe. In some cases, individuals are advised to remain immobile for a short period. Most of the exercises are advised to start after the removal of sutures. 

The following recovery tips help heal the wound faster and reduce pain.

• Keep the dressings dry for at least two weeks

• Massage the affected area after the removal of the bandage

• Keep the feet elevated for the first few weeks to reduce pain

• Apply ice packs on the foot for 30 minutes every 1-2 hours during the first few days 

• Avoid putting weight on your foot

Home-care For Bunions

A few home remedies can help manage bunions. However, make sure to consult your healthcare provider before initiating any of these:

1. Hot and cold therapy

Hot and cold therapy for the affected part can give some respite from painful and swollen bunions.

Cold therapy involves soaking a bunion in cold water. This reduces swelling by constricting the blood vessels. 

Soaking the feet in warm water helps manage soreness by improving blood flow. 

Ice and heating packs can also be used instead of soaking feet in water.

Buy hot and cold packs with just a single click.
Shop Now

2. White vinegar

Vinegar helps in softening the hard skin. It also possesses antibacterial and antifungal properties. 

It can be applied by mixing three parts vinegar with one part water. Apply the solution to the affected part and cover it with the bandage. Leave it overnight for the best results. 

3. Olive oil

Olive oil increases blood circulation and helps to alleviate pain. It can be directly massaged for 10-15 minutes every day.  

4. Castor oil

Castor oil possesses anti-inflammatory properties, which help reduce bunions' swelling and pain. It can be used by wrapping a cloth dip in warm castor oil around the affected area. 

5. Epsom salt

It also possesses anti-inflammatory properties. Soak the feet in warm water with Epsom salt. 

Alternative Therapies For Bunion

Foot exercises

Foot exercises are beneficial in maintaining the strength and flexibility of the feet. Individuals with bunions are advised to perform at least three sets of the following exercises daily:

• Pickups: This involves picking up 10 to 20 small objects from a seated position using toes.

• Curls: This activity involves curling the towel on the floor while sitting on the chair. The toes are then curled around the towel and pulled towards yourself by bending the knees. 

• Stretches: In this exercise, toes are kept pointed and then curled for 5 seconds. For maximum effect, this activity is repeated at least ten times. 

• Rolling: This involves moving the object along and around the length of each foot for two to three minutes.

Complications Of Bunion

The constant pressure on the big toe can lead to several complications. This include:

• Corns and Calluses (thick, rough and hardened layers of skin)

• Pointing up of toe head

• Inflammation of the bursae – fluid-filled sacs that cushion the bones, tendons and muscles near the joints)

• Pain and swelling in the ball of your foot

• Deformation of the toe nails

• Difficulty in walking

How to get rid of corns and calluses?
Find Out Now