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Overview

A bunion develops when the joint at the base of the big toe becomes swollen and most likely painful. The American Academy of Orthopaedic Surgeons suggests these ways to ease bunion pain. Make sure shoes fit properly and comfortably, and mold to the shape of your feet. Opt for shoes with a soft sole, wide toe box and wide instep. Avoid heels of more than 2 1/4 inches, those that are too tight, and shoes with pointy, narrow toes. To accommodate a bunion, wear shoes that are a bit big, or have your shoes professionally stretched. Place a protective cushioned pad over the bunion.

Causes
Women traditionally have a higher rate of bunions, which is to be expected, since it is they who have traditionally worn shoes with high heels, a narrow toe box, or whatever fashion dictates from year to year. However, men can suffer from bunions as well, as can anyone for whom the right (or wrong) conditions exist, poor foot mechanics, improper footwear, occupational hazards, health and genetic predisposition. Finally, bunions have long been a condition associated with the elderly, and although they often appear in conjunction with inflammatory joint diseases such as arthritis (which is often associated with age), they can strike at any point in life, including adolescence.
SymptomsSymptoms include pain in and around the ball of the big toe, usually from the bone rubbing too much against the shoe. You may be unable to wear certain types of shoes due to the shape of the forefoot. The big toe appears to be bent inwards towards and in come cases over the inside toe.

Diagnosis
Your doctor is very likely to be able to diagnose your bunion simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to determine the extent of your deformity.

Non Surgical Treatment
Conservative Treatment. Apply a commercial, nonmedicated bunion pad around the bony prominence. Wear shoes with a wide and deep toe box. If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling. Avoid high-heeled shoes over two inches tall. See your podiatric physician if pain persists. Orthotics. Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity. Padding & Taping. Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain. Medication. Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammations caused by joint deformities. Physical Therapy. Often used to provide relief of the inflammation and from bunion pain. Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement.


Surgical Treatment
Recent advances in surgical techniques have led to very high success rates for bunion surgery. In most cases the patient can walk immediately after surgery without crutches. As well most patients find the surgery to be virtually pain free. Almost all bunion surgery is done as an outpatient at a surgery center. Most bunion surgery is performed with a local anesthetic block and IV sedation (twilight sleep). After the procedure you will be moved to the recovery room for about an hour. You will then be ready to go home.

Prevention
Bunions often become painful if they are allowed to progress. But not all bunions progress. Many bunion problems can be managed without surgery. In general, bunions that are not painful do not need surgical correction. For this reason, orthopaedic surgeons do not recommend ?preventive? surgery for bunions that do not hurt, with proper preventive care, they may never become a problem.