A bunion forms when the bursa (a sac of fluid at friction points between the tendons and bone in some areas and between bone and the skin in others) becomes inflamed along the edge of the joint at the base of the big toe. There are two types of bunions. The acute bunion causes the sharper pain. It develops from a bursitis, a sudden outcropping of a fluid-filled sac. An acute bunion can progress into the second type of bunion, the hallux valgus, a chronic but often painless deformity involving permanent rigidity of the bones. Bunions can form in any part of the foot but occur most often at the big toe joint, where the first metatarsal bone abuts the proximal phalanx of the big toe. Women are more likely than men to get bunions because of the misshapen footwear and elevated heels they wear. Causes
Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function, or arthritis, but is more commonly caused by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion. Women who have bunions normally wear dress shoes that are too small for their feet. Their toes are squeezed together in their shoes causing the first metatarsal bone to protrude on the side of the foot. It is important for men and women to realize that wearing dress shoes and boots, which are tapered in the toe area, can cause the bunion to worsen to the point where surgery is necessary. Symptoms
Symptoms of a bunion include irritated skin, sensitivity to touch, and pain when walking or running. Since the bunion may grow so prominent as to affect the shape of the foot, shoes may no longer fit properly, and blisters may form at the site of friction and pressure. Bunions may grow so large that an individual must wear shoes that are a larger size than they would otherwise wear. If the bunion becomes a severe case, walking may become difficult. Diagnosis
Looking at the problem area on the foot is the best way to discover a bunion. If it has the shape characteristic of a bunion, this is the first hint of a problem. The doctor may also look at the shape of your leg, ankle, and foot while you are standing, and check the range of motion of your toe and joints by asking you to move your toes in different directions A closer examination with weight-bearing X-rays helps your doctor examine the actual bone structure at the joint and see how severe the problem is. A doctor may ask about the types of shoes you wear, sports or activities (e.g., ballet) you participate in, and whether or not you have had a recent injury. This information will help determine your treatment. Non Surgical Treatment
Apply a commercial bunion pad around the bony prominence, use only non-medicated pads. Wear shoes with a wide and deep toe box. You should be able to "dimple" the leather over your bunion. Avoid all high heeled shoes. If your bunion becomes painful red, and swollen try elevating your foot and applying ice for about 20 minuets every hour. If symptoms persist, consult your podiatrist or physician. Surgical Treatment
Bunions are painful deformities that develop when your big toe and first metatarsal slide out of alignment. Most of the time, this condition can be managed and your pain relieved using entirely conservative measures. Since this is a bone deformity, however, the problem can?t be truly corrected without a surgical procedure. Surgery for bunions realigns the displaced bones and restores the foot?s normal function. Prevention
To help prevent bunions, select your style and size of shoes wisely. Choose shoes with a wide toe area and a half-inch of space between the tip of your longest toe and the end of the shoe. Shoes also should conform to the shape of your feet without causing too much pressure.
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