Bunion. Image credit: Flickr
Bunion. Image credit: Flickr

A bunion is a bony lump at the outer side of a human toe. In other words, it’s a deformity of the big toe metatarsophalangeal joint (MTPJ). The lump usually develops when the big toe points inward and the foot’s first metatarsal bone turns outward, which causes the MTPJ to obtrude. A fluid-filled sac called bursa encompasses and shields the joint. When subjected to pressure, the sac gets flamed up, leading to the whole joint turning painful and stiff. If left untreated, the bunion may get worse. According to some studies, bunion occurrence is 10 times higher in women than men.

Symptoms and Signs

There are not many bunion symptoms. One obvious indication is pain in the affected area when wearing shoes or walking. Soreness, redness, and numbness are also possible symptoms. If getting shoes that fit right is a hassle, a bunion could be the issue.

Causes

  • Wrong-Size Footwear: A bunion is impending when the foot is frequently jammed into ill-fitting or pointed-toe, narrow footwear. However, an inappropriate shoe only triggers an already existing bunion – it isn’t the primary cause.
  • High Heels: High heels could aggravate the issue as wearing them pushes the body weight forward, thereby tipping the toes to the front. This is perhaps the reason why bunions are more common in women.
  • Heredity: Generally, a bunion is hereditary. This means the foot’s bones may have an abnormal formation right at birth. Some types of feet are more vulnerable to the condition. For instance, flat feet, low arches, and loose tendons and joints increase the risks. The metatarsal head (first metatarsal bone’s top) shape makes a difference too. A rounded metatarsal head is less stable and prone to deformities when squeezed into narrow-toe shoes.
  • Recurring Stress: People in the nursing and teaching industry, wherein a lot of walking and standing is the norm, have higher chances of developing bunions. Also, individuals in any field or profession that entails excessive pressure on the feet could develop bunions, such as ballet dancers.
  • Pregnancy: During a pregnancy, women may experience several foot problems, including bunions, because the hormonal changes happening within the body loosen the ligaments, leading to feet flattening.
  • Arthritis: A bunion is also linked with specific arthritis types such as rheumatoid arthritis (inflammatory type), which damages the joint cartilage.

Resulting Issues

A bunion can seriously sabotage the foot’s basic functioning. It may lead to ingrown nails, and calluses could form under the foot. If the body weight is constantly shifted off the affected big toe to avoid pain, the foot’s ball may come under immense discomfort. If the bunion is ignored, exercises and other physical activities may not be possible. In fact, walking would become difficult as well.

Diagnosis and Treatment

Image credit: Flickr
Image credit: Flickr

To determine a bunion’s severity, doctors usually resort to X-rays and measure the angle between specific foot bones. Generally, the pain can be relieved and the bunion prevented if the MTP joint is put off physical stress and pressure. However, if the underlying deformity cannot be corrected non-surgically or the pain gets excruciating, a bunionectomy (surgery) is the only option. The surgery’s success depends on how well the foot is taken care of after surgery, since there are chances of the big toe shifting back to the deviated position again.

  • Proper Shoes: The right shoes can immensely relieve pressure. The shoes must be wide and have a flexible sole for supporting the foot. The shoe’s toe area must have sufficient space to house the bunion. Athletic shoes or shoes made of soft leather, sandals, etc. are some good options. The heels should be kept low, preferably not more than an inch.
  • External Equipment: A moleskin is a soft pad that can be placed inside the shoes to cover the bunion. The shoe must be roomy enough to accommodate the pad, with no squeezing. Based on the foot structure and bunion severity, a semi-soft foot orthosis could be recommended by the doctor to help with correct positioning when the foot touches the ground. A splint can be worn at night to help with correct toe position and decreasing discomfort.
  • Pain Relief: If the bunion turns painful and irritating, ice packs, warm soaks, and anti-inflammatory nonsteroidal drugs such as ibuprofen or aspirin could help. A massage or whirlpool would offer relief too. Cortisone injections provide temporary relief from inflammation, but the side effects are plenty, particularly in cases of frequent doses. For proper advice, a doctor consultation is imperative.           
  • Exercises: Stretching exercises can be done to decrease tension on the bunion joint’s inner portion.
  • Going Barefoot: A barefoot lifestyle is recommended because bunion complaints are reportedly higher in individuals who wear shoes than people who mostly don’t have their shoes on.