A bunion looks like a bump on the inside of the foot where the big toe joins the foot. Over time, the bunion gets worse. The big toe starts to lean toward neighboring toes instead of pointing straight ahead. (The scientific name for this is hallux valgus or hallux abducto valgus.) The bump is a sign that the bones of the foot are out of alignment. While shoes with high heels or pointed toes may cause the joint to ache, they don't cause bunions. Most often they are due to an inherited foot structure. The tendons and ligaments that hold bones and muscles together at the joint are not working as they should. This structure makes it more likely that a person will develop a bunion.
Bunions are the byproduct of unnatural forces and motion being applied to the joints and tendons of your foot over a prolonged period of time. They can also be caused by traumas to the foot as well as congenital deformities. Occupations or athletic activities that place abnormal stress on your feet can also lead to the formation of bunions. Bunions have a tendency to run in families, but it?s not the bunion itself that is hereditary. It?s the the foot type which *causes* the bunion that is hereditary. Also, wearing shoes such as high heels that do not distribute your body weight evenly can lead to bunions, which explains why so many women suffer from bunions.
While bunions may be considered cosmetically undesirable, they are not necessarily painful. In cases where the individual has minor discomfort that can be eased by wearing wider shoes made of soft leather and/or with the aid of spacers-padding placed between the toes to correct alignment-further treatment may not be necessary. (Anti-inflammatory agents can be used to alleviate temporary discomfort at the site of the bursa.) For those who continue to experience pain on a daily basis and who cannot wear most types of shoe comfortably, surgical treatment may be the best choice.
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
Custom orthoses or over-the-counter insoles to aid big toe joint function, help control over-pronation and maintain proper alignment of the bones in the feet. Properly sized, supportive footwear that are torsionally stable (can?t be folded or twisted easily) and that feature a good ?rocker profile? (curved from the ball to tips of the toes) help to reduce stress on the joint when walking. Footwear modifications to expand the area of the shoe surrounding the bunion to relieve pressure. Physical therapy modalities include rest, icing and massage. Injections, surgery and other treatment options, please consult your medical doctor for information and/or referral to a podiatrist or other foot and ankle specialist.
Bunion surgery is most often a day case or one night in hospital. Surgery can be done under ankle block (patient awake) or general anaesthetic. It is best to rest with the foot elevated for the first 2 weeks after surgery. The foot is bandaged and a special sandal supplied by the hospital is worn for 6 weeks. Sensible shoes are to be worn for a further 6 weeks after the bandages are removed. It will take between 3-6 months for the swelling to go down. It will take 12 months before everything completely settles. It is also important to remember that not all bunion operations are entirely successful.