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Overview

A bunion, also known as hallux valgus, is a painful deformity that develops at the base of the big toe. Bunions are caused when the big toe pushes and bends inward towards the other toes. This displaces the bones of the joint, causing it to protrude in a way that looks like a large growth. Bunions develop due to a variety of factors. Some people inherit feet that are more susceptible due to their shape and structure, having flat feet for instance. But bunions can be made worse by the wrong shoe, or by carrying extra weight or prolonged periods of standing or walking.

Causes
Although bunions tend to run in families, it is the foot type that is passed down-not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.
SymptomsPatients with bunions will often display pain over the prominent bump on the inside of their forefoot (the medial eminence?). However, they may also have pain under the ball of the foot (under the area near the base of the second toe). Symptoms can vary in severity from none at all to severe discomfort aggravated by standing and walking. There is no direct correlation between the size of the bunion and the patient?s symptoms. Some patients with severe bunion deformities have minimal symptoms, while patients with mild bunion deformities may have significant symptoms. Symptoms are often exacerbated by restrictive shoe wear, particularly shoes with a narrow toe box or an uncomfortable, stiff, restraining upper.

Diagnosis
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by Arthritis, which causes destruction of the cartilage of the joint. Gout, which causes the accumulation of uric acid crystals in the joint. Tiny fractures of a bone in the foot or stress fractures. Infection. Your doctor may order additional tests to rule out these possibilities.

Non Surgical Treatment
Many people with bunions are quite comfortable if they wear wide, well fitting shoes and give them time to adapt to the shape of their feet. A small pad over the bony prominence, which can be bought from a chemist or chiropodist, can take the pressure of the shoe off the bunion. High heels tend to squeeze the foot into the front of the shoe and should be avoided. It is often worthwhile seeing a chiropodist if these simple measures are not quite enough.


Surgical Treatment
If other treatments don?t help and your bunion is very painful, you may be referred to an orthopaedic or a podiatric surgeon for assessment. There are over 130 different operations that can be carried out to treat bunions. The simplest operations are called bunionectomies. The majority of the operations aim to correct the alignment of your big toe. This will narrow your foot and straighten out your big toe joint as much as possible. An operation won?t return your foot back to normal, but most people find that surgery reduces their symptoms and improves the shape of their foot. The operation your surgeon will advise you to have will depend on how severe your bunion is and whether or not you have arthritis.