Hallux Valgus Symptoms And Treatment
People think of a bunion as being as a bump on the side of the foot near the big toe. However, bunions go deeper than what we can see. Although the skin might be red, a bunion actually reflects a change in the anatomy of the foot. Bunions happen over time. What begins as the big toe pointing toward the second toe ends up as changes in the actual alignment of the bones in the foot. There is also a condition called tailor?s bunion or bunionette. This type of bump differs from a bunion in terms of the location. A tailor?s bunion is found near the base of the little toe on the outside of the foot.
Bunions are among the most common problems of the foot. They are several possible reasons a bunion may develop, though a biomechanical abnormality (improper function of the foot) is the most common cause. In an unstable flat foot, for example, a muscular imbalance often develops that, over time, causes bunions. Bunions tend to run in families, and most podiatrists believe that genetic factors play a role in predisposing some people to develop bunions. Poor shoes, like high heels and pointed toe boxes–exacerbate the condition by speeding up the development of bunions, and by making bunions more painful. Poor shoe choices is at least one of the reasons bunions are much more common in women than men.
SymptomsBunions typically start out as a mild bump or outward bending of the big toe. Bunions at this stage are usually only a concern of appearance at this stage, and at this point they often don’t hurt much. Over time, the ligaments that connect the bones of the toe stretch out, and the tendons attaching to the big toe gradually pull it farther and farther towards the second toe. Sometimes patients will find their first and second toes begin to press together too much, and they’ll often get a painful corn between those toes. As the bunion progresses, the big toe may begin to ride on top of the second toe, or vice versa, creating a second deformity. Others will develop bump pain at the site of the bony enlargement on the side of the foot. A painful bursa may develop at that site. This is particularly true in tight shoes. Many patients also develop a painful callus beneath the foot. Capsulitis and other types of metatarsalgia may develop in the joints beneath these calluses, particularly in the second and third metatarsophalangeal joints (the joints in the ball of the foot). Over time, with the toe held in a crooked position for enough time, arthritis develops in the big toe joint. This will usually result in decreased range of motion of that joint (a condition known as “Hallux Limitis”), which as a result, often causes the patient to changes in the way a patient walks. Often the patient walks in an “out-toed”, or duck-like, fashion, which very frequently causes secondary pain in the legs, knee, hip, and low back.
Diagnosis begins with a careful history and physical examination by your doctor. This will usually include a discussion about shoe wear and the importance of shoes in the development and treatment of the condition. X-rays will probably be suggested. This allows your doctor to measure several important angles made by the bones of the feet to help determine the appropriate treatment.
Non Surgical Treatment
Bunions are progressive problems, meaning they tend to get worse over time. Sometimes severe-looking bunions don’t hurt much, and sometimes relatively modest-looking bunions hurt a great deal. Thus, treatment varies depending upon a patient’s symptoms. You can often improve the discomfort of bump pain by a change to more proper shoes. Alternatively, alterations to existing shoes may improve pain associated with bunions. Accommodative padding, shields and various over-the-counter and custom-made orthopaedic appliances can also alleviate bunion pain. Anti-inflammatory medications, steroid injections, physiotherapy, massage, stretching, acupuncture and other conservative treatment options may be recommended by your podiatric physician to calm down an acutely painful bunion. Long term, orthoses (orthotics) can address many of the mechanical causes of a bunion. Thus, while orthoses don’t actually correct a bunion deformity, if properly designed and made, they can slow the progression of bunions. They can also be made to redistribute weight away from pain in the ball of the foot, which often accompanies bunion development. Padding, latex moulds and other accommodative devices may also be effective. While they don’t correct the misalignment in the bones, they may alleviate pain. Often, though, when conservative measures fail to alleviate pain associated with the bunion, when you start to limit the types of activities you perform, when it’s difficult to find comfortable shoes, and when arthritis changes how you walk, surgery may be the best alternative.
Some sufferers choose to have the bunion surgically removed. This should always be a last resort as all surgeries carry risks. There are several types of surgical procedures to remove bunions and before deciding, you should speak to your surgeon at length about the facts and risks associated with surgery, including the recovery time and success rate of the operation to be done. Please note that if you have a surgical procedure and then return to your high heels and narrow-toed shoes, the bunion is likely to reoccur.
Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. Medicine will not prevent or cure bunions.