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Overview

A foot bunion is a common cause of foot pain caused by deformity of one of the toe bones. They most commonly affect the big toe, known as hallux abducto valgus, but can also affect the little toe, known as a bunionette. The classic presentation is a large bump on the outer side of the big toe that is red, swollen and painful caused by the toe deviating across towards the second toe. Left untreated, the condition usually gets gradually worse, so it is important to get treatment early on else you may end up needing bunion surgery.

Causes
Bunions form when the normal balance of forces exerted on the joints and tendons of your feet are disrupted. This can lead to instability in the big toe joint - also known as the first metatarsophalangeal (MTP) joint, causing a deformity. Bunions develop over years of abnormal motion and pressure on your big toe joint. They often result from a combination of your inherited foot type, faulty foot mechanics that affect the way you walk and shoes that fit improperly. Other causes of bunions include foot injuries. Deformities present at birth (congenital). Neuromuscular disorders, such as cerebral palsy or post- polio syndrome (post-poliomyelitis). Bunions may be associated with various forms of arthritis, including inflammatory or degenerative, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet also can be a cause. Waiters, factory workers, dancers and athletes often are more prone to developing bunions.
SymptomsWith the positional change of the hallux, pain is a common occurrence. As the foot goes through the gait cycle the hallux plays an integral role as the body's weight transmits through during propulsion. With this in mind, it easy to see how the change in the hallux joints (metatarsal phalangeal joint and the proximal interphalangeal) would cause joint narrowing and early degeneration of the articular cartilage. In addition, two small bones (ossicles) found underneath just behind the joint will start placing extra pressure on the metatarsal. Along with bony changes, there are many soft tissue changes as the hallux and metatarsal reposition, which causes added strain to other bony structures and can accelerate the problem.

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
Podiatrists will treat bunions conservatively, using paddings and orthotics, which are devices that are made to protect the joint or deviate pressure away from it. Sometimes bunions will develop overlying callus or corns. These can be removed by a podiatrist, but if the area is irritated again by wearing ill-fitting footwear, the corn will grow back. Most people with this condition have flat feet, so arch supports are often recommended.


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.