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Overview

The classic bunion is a bump on the side of the great toe joint. This bump represents an actual deviation of the 1st metatarsal. In addition, there is also deviation of the great toe toward the second toe. In severe cases, the great toe can either lie above or below the second toe.

Causes
Bunions are more common in women than men. The problem can run in families. People born with abnormal bones in their feet are more likely to form a bunion. Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion. The condition may become painful as the bump gets worse. Extra bone and a fluid-filled sac grow at the base of the big toe.
SymptomsIf a foot bunion is developing, you may experience some of these symptoms. Bulge or bump on the outside of the base of your big toe. Swelling. Redness. Soreness. Thickening of the skin in that location. Corns or calluses. Limited movement of your big toe. Persistent or periodic pain. The pain you experience may be mild or severe. It may become increasingly difficult to walk in your normal shoes. The pressure on your other toes can cause your toenails to grow inward or your smaller toes to become bent.

Diagnosis
A simple visual exam is all it will take for your doctor to determine whether you have a bunion. He or she may also ask you to move your big toe in order to ascertain your range of motion. Your doctor may also look for any inflammation, redness, or pain. X-rays can help your doctor determine the severity and cause of the bunion. Your doctor may also ask you questions about your footwear, the symptoms you are experiencing, and if other family members also suffer from the condition. All these factors will help him or her diagnose you properly.

Non Surgical Treatment
Your doctor may recommend a prescription or over-the-counter pain reliever, as well as medication to relieve the swelling and inflammation. A heat pad or warm foot bath may also help relieve the immediate pain and discomfort. A few people may obtain relief with ice packs. If your bunion isn't persistently painful and you take action early on, changing to well-made, well-fitting shoes may be all the treatment you need. Your doctor may advise use of orthoses (devices that are used to improve and realign the bones of your foot), including bunion pads, splints, or other shoe inserts, provided they don't exert pressure elsewhere on the foot and aggravate other foot problems. In some cases, an orthotist (someone trained to provide splints, braces and special footwear to aid movement, correct deformity and relieve discomfort) can recommend shoes with specially designed insoles and uppers that take the pressure off affected joints and help the foot regain its proper shape.


Surgical Treatment
If your bunion is symptomatic and causing you persisting and troublesome symptoms then surgery should be considered. There is no correct amount of pain or inconvenience which a bunion may cause which warrants surgery. Symptoms which a bunion causes are generally subjective, and what is a problem in one person?s view will not be a problem in another's. For bunion surgery to be successful (correcting the deformity and losing the symptoms) the mechanical factors driving the deformity should be overcome. Bunion surgery should replace the 1st metatarsal closer to the 2nd thus reducing the width of the foot, and also realigning the tendons and reducing their deforming forces. These principals of bunion surgery are well demonstrated by the following x-rays which shows how a Scarf osteotomy has achieved this aim.