Bunions Reasons Signs And Symptoms And Solutions
OverviewA bunion is a deviation and inflammation of joint where the big toe connects to the 1st metatarsal, also known as the 1st MTP. The capsule of the joint is displaced, thickened and enlarged, and the cartilage of the joint is damaged. There are three degrees of bunions: mild, moderate and severe. It is important to know that bunions are not hereditary, although the tendency to overpronate, which is one of the main causes of bunions, has a hereditary component. Patients complain of pain in the joint and have a big toe that points away from the midline of the body. Often, they are only able to wear very wide shoes. CausesContributing factors may include excessive foot pronation, wearing tight and pointed-toe shoes, and occasionally trauma. Joint misalignment causes osteoarthritis with cartilage erosion and exostosis formation, resulting in joint motion being limited (hallux limitus) or eliminated (hallux rigidus). In late stages, synovitis occurs, causing joint swelling. In reaction to pressure from tight shoes, an adventitious bursa can develop medial to the joint prominence, which can become painful, swollen, and inflamed. SymptomsThe symptoms of a bunion include the following development of a firm bump on the outside edge of the foot, at the base of the big toe, redness, swelling, or pain at or near the MTP joint, corns or other irritations caused by the overlap of the first and second toes, restricted or painful motion of the big toe. DiagnosisMost patients are diagnosed to have bunions from clinical history and examination. However, in some cases, X-rays will be performed to determine the extent of damage to the joint. Furthermore, it will enable the treating doctor to decide on the best course of management of the patient. Non Surgical TreatmentBunions may be treated with proper shoes and corrective inserts such as toe spacers, bunion or toe separators, as well as bunion cushions and splints. In extreme cases, surgery may be needed to remove the bony enlargement of the first metatarsal bone, realigning the bone, or straightening the big toe. Surgical TreatmentLarger bunions are commonly treated with the Lapidus Bunionectomy, which involves realigned the displaced bone at its bottom, through a bone mending/fusion procedure. It is with this technique where the the walking advances have been made int he past decade. The Lapidus Bunionectomy has become a popular surgical method since surgeons have become more comfortable with mobilizing their patients post-operatively. Though not all surgeons who perform this procedure have adopted this postoperative protocol. PreventionIf the diagnosis is made early on, such as in preadolescence, bunion development can be slowed and in some cases arrested with the proper supportive shoe gear and custom functional shoe inserts (orthotics). Avoidance of certain athletic activities with improper shoe fit and toe pressure can prevent the symptoms that occur with bunions.