Causes Of Bunions

Overview

A bunion is an often painful enlargement of bone or tissue around the joint at the base of the big toe. If you have a bunion, you will notice a bump on your big toe joint. The big toe may turn in toward the second toe and the tissues surrounding the joint may be swollen and tender. Bunions can come from a variety of causes, including diabetes, rheumatoid arthritis, or foot mechanics that place too much load on the ball of your foot. If untreated, bunions can worsen, leading to other serious complications, and even potentially require surgery. Early treatment is best, so if you?re suffering from bunions it?s smart to see a podiatrist for proper treatment and care.

Causes
The commonest cause of bunions is prolonged wearing of poorly designed shoes such as the narrow high heels that women wear. This is one of the reasons why bunions are much more common in women than in men. There is also a hereditary component to bunions in that many times we will see a grandmother, mother and daughter all with various stages of bunions. 38% of women in the United States wear shoes that are too small and 55% of women have some degree of bunion formation. Bunions are 9 times more common in women than they are in men.
SymptomsBunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike, some bunions progress more rapidly than others. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.

Diagnosis
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.

Non Surgical Treatment
Bunions can develop at any time. Although bunions often require no medical treatment you should consult your family doctor/chiropodist/podiatrist. Treatment options vary depending on the severity of your bunion and the amount of pain it causes you. Although they don't always cause problems, bunions are permanent unless surgically corrected. If the cushioning sac of fluid (bursa) over the affected joint becomes inflamed (bursitis), a bunion can be very painful and interfere with your normal activities. Bunions may get larger and more painful, making nonsurgical treatment less effective. Apply a non-medicated bunion pad around the bony bump. If a bunion becomes inflamed or painful, apply an ice pack two to three times daily to help reduce swelling. Wear shoes with a wide and deep toe box. Avoid shoes with heels higher than 2 inches (5.1 centimeters).


Surgical Treatment
There are many different procedures described to correct bunions. You should be aware that usually just shaving the bunion off, although it is attractive and minimally invasive, is usually not enough. Initially the foot will look much better but with time the bunion will recur. Arthrodesis refers to surgery performed on the great toe joint where the joint is fused. This is usually reserved for people with very severe deformities when other surgical options are impossible. Bunionectomy refers to the simple removal of the bunion itself. This is seldom used because it doesn?t correct the underlying bone problems. Osteomety is the commonest surgical procedure. The bone is cut and the bones realigned and pinned in place until they heal so that the underlying bone deformity is corrected and the bunion will not recur. The resection arstplasty refers to the removal of the toe joint and this creates a flexible scar that functions as the joint instead. In the past there has been some interest in implanting artificial joints but this has fallen out of favor due to the fact that they usually do not hold up with the normal every day stress that people put their feet through.

Prevention
A lot of bunion deformities are hereditary so there isn't much you can do to fully prevent them. Early detection and treatment will go a long way in preventing the growth of the bunion and foot pain. Often times, a good custom orthotic can be very effective in slowing the progression of a bunion, but a podiatrist provides that. Waiting with bunions will worsen the condition and could lead to further complications such as hammertoes or contracted toes. Besides causing deformity, these secondary conditions can eventually cause issues with walking and affect your knees, hip, lower back. There are no lotions over the counter that would be able to actually treat the problem. There are some bunion shields that you can place on the bump to ease symptoms and pressure from shoes. However because this condition is an actual bone deformity, the over the counter option solutions are more like a Band-aid approach.