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Bunions

A bunion is a painful bony bump that develops inside the foot at the big toe joint. They are related to hallux valgus, a condition where the big toe drifts toward the smaller toes and the outside of the foot.

Bunions usually develop slowly, and pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal position of the bone, tendons, and ligaments changes, resulting in bunion deformity. Frequently, this distortion gradually worsens over time and may make it painful to wear shoes or walk.

What are the types of bunions?

Bunions can pose problems whether they persist after childhood or develop in adulthood. The types of bunions include:

  • Congenital bunions:  Congenital bunions are inherited and often noticed by the patient in their teenage years. This is caused by genetics and the way bones form in the foot. Hereditary bunions are often non-progressive but still may become arthritic with time.
  • Bunion with Hallux Limitus:  Also called hallux rigidus, a hallux limitus bunion limits flexibility in the foot, particularly at the big toe joint. This condition can cause jamming of the big toe, eventually causing a bunion to form at the top of the big toe’s base joint (instead of on the side).
  • Tailor’s bunion: A tailor’s bunion develops on the pinky toe instead of the big toe. It is often called a bunionette. Tailor’s bunions can cause the pinky toe to change direction, and a protrusion can develop in the area.
  • Bunion with Skin Irritation: This is most common in people with bunions and wearing closed or tight shoes. The tightness of the shoe and the protrusion at the big toe can cause friction and irritation of the skin.

What causes bunions?

It is observed that the primary cause of bunions is problems with bone structures in the feet, and Bunions tend to run in families. 

Factors that are known to increase the risk of bunions include: 

  • Wearing improperly fitting shoes (particularly narrow pointed toe and(or) high-heeled shoes)
  • Certain arthritic conditions (for example, rheumatoid arthritis) and ligament disorders
  • Age (the incidence of bunions increases with age)
  • Being flatfooted with feet that roll inwards (over-pronation)
  • Past injury (trauma) to the foot
  • Nerve conditions affect the foot.

Bunions most commonly affect women. Bunions are also more common in people who routinely wear shoes and whose jobs involve a lot of standing and walking, for example, nurses and teachers.

What are the symptoms of bunions?

Symptoms of bunions tend to increase over time as the condition worsens. Typical symptoms include: 

  • Growth of a bony lump at the side of the big toe joint
  • Pain when walking (particularly during the “push-off” phase)
  • Discomfort, redness, and tissue swelling (bursitis) over the big toe joint, with thickening of the overlying skin
  • Overlapping of the big toe above or below the second toe.
  • Deformity of the big toe joint.

How are bunions diagnosed?

Doctors at Fulshear Foot and Ankle can diagnose a bunion through a visible check-up since many signs are outwardly present.

The doctor can gently move the toe to determine if a bunion restricts the range of motion or causes pain, numbness, or tingling in the toe or foot.

A doctor at Fulshear Foot and Ankle may suggest additional diagnostics if they suspect the deformity or injury.

  • If a bunion causes significant pain or severely changes the shape of the big toe, doctors may recommend X-ray imaging. 
  • The doctor can suggest an ultrasound imaging at Fulshear Foot and Ankle. If your symptoms include tingling or numbness in the foot, the doctor suspects inflammation in the nerves between the bones of the feet and toes.
  • The doctor may recommend an MRI scan if they suspect changes in the foot’s bone structure may have led to other types of damage.

The doctor may also ask you to walk a few steps to see how the bodyweight is distributed across your foot and toes.

How are bunions treated?

Two main options are available to treat bunions actively:

  • Nonsurgical option.
  • Surgery.

Nonsurgical option

Nonsurgical options include:

  • wearing padded sole shoes which provide adequate wiggle room for your toes
  • taking over-the-counter pain relievers such as acetaminophen, ibuprofen, or naproxen
  • wearing over-the-counter arch supports in your shoes

Surgery

Some people with bunions may need surgery, which may be suitable for people who:

  • experience pain and inflammation that does not improve with other treatments
  • have a deformity severe enough that the toe may cross over another toe
  • cannot bend or straighten a toe due to stiffness

Bunion surgery very rarely occurs in younger people with bunions.

How can you prevent bunions?

  • Choose footwear that fits correctly.
  •  Always stand when trying on shoes to ensure they still fit comfortably when the foot expands under your body weight. 
  • Try shoes on both feet and select the size appropriate for your larger foot.
  •  Use an extra insole if one shoe is looser than the other. 
  • Do not cramp the larger foot.

What is the prognosis for people who have bunions?

When it comes to the overall outlook and possible prevention of bunions, taking the best care of the feet and making sensible choices in footwear.

  • Shoes that fit well and have plenty of toe room.
  • Purchasing shoes with extra depth can help to give feet extra space and required comfort.
  • To avoid irritation or pain, make use of accessories like moleskin, felt or gel-filled pads, orthotics, and toe-spacers.

How Fulshear Foot and Ankle can help you?

You should visit us at Fulshear Foot and Ankle if you are experiencing problems like:

  • A visible bump on your big toe joint
  • Decreased movement of your big toe or foot
  • Difficulty finding shoes that fit correctly because of a bunion
  • Ongoing big toe or foot pain
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