Home > Foot Problems > Bunions
| * Explanation | * Symptoms | * Diagnosis | * Duration |
| * Prevention | * Treatment | * Call your Doctor | * Prognosis |
A bunion (hallux valgus) is a painful, inflamed enlargement of a bony bump at the base of the big toe. As a result, the big toe joint enlarges and the toe is pushed inward into a position where it overlaps the second toe.
Bunions tend to be inherited, but they are also prevalent among the following specific groups: women who wear high heels; people who wear shoes that are too narrow or too pointed; or people with flat feet. All of these situations force the big toe to drift toward the little toes, and this fosters bunion formation.
The dominant symptom of a bunion is a big bulging bump on the inside of the base of the big toe. Other symptoms include swelling, soreness and redness around the big toe joint; a tough callous at the bottom of the big toe; and persistent or intermittent pain.
What your doctor looks for
Before examining your foot, the doctor will ask you questions about the types of shoes you wear and how frequently you wear them. He or she will also ask if anyone else in your family has had bunions, or if you've had any previous injury to the foot.
In most cases, a bunion can be accurately identified by a simple physical examination of your foot. During this exam, you will be asked to move your big toe up and down to determine if there is any limited range of motion. The doctor will also look for signs of redness and swelling and ask about the presence of any pain. After the physical exam, foot X-rays are often taken to assess the severity of the condition.
A bunion may develop at any time during childhood or adulthood. It will remain as a persistent foot problem until corrective action is taken.
To help prevent bunions, select your style and size of shoes wisely. For example, try choosing shoes with a wide toe box (a half-inch of space between the tip of your longest toe and the end of the shoe). Shoes should also conform to the shape of your feet without causing undue pressure.
Treatment options are based on the severity of the deformity and the symptoms. Fortunately, non-surgical treatments are usually sufficient to relieve the pain and pressure on the big toe. Your doctor may tell you to start wearing roomy, comfortable shoes with toe pad inserts, or with a special corrective device that slips into your shoes to push the big toe back into its proper position. Aspirin or over-the-counter acetaminophen can provide pain relief. Whirlpool baths may also help to ease discomfort.
To end persistent pain, your doctor may recommend specific foot surgery (a "bunionectomy") to remove the bunion and reshape the foot. During the operation, the swollen tissue will be removed, the big toe will be straightened, and the bones of the affected joint may be permanently joined. The goal of the surgery is to correct the cause of the bunion and to prevent the bunion from growing back. After surgery, pain medication will be prescribed and specific instructions will be given concerning when to begin moving the toes and ankles.
Contact an orthopaedic surgeon or podiatrist for the following bunion symptoms: persistent pain; a very visible bunion "bump"; mobility of the toe or foot is reduced; shopping for shoes with the proper fit becomes difficult.
In patients treated with bunionectomy, the prognosis is excellent for long-term relief from discomfort and deformity. In the short-term, it may take two months or more before a bunionectomy patient is able to exercise regularly.