A bunion is an unnatural, bony hump that forms at the base of the big toe where it attaches to the foot. Often, the big toe deviates toward the other toes. When this occurs, the base of the big toe pushes outward on the first metatarsal bone, which is the bone directly behind the big toe, forming a bunion. If this happens on the little toe and fifth metatarsal, it's called a bunionette. Because a bunion occurs at a joint, where the toe bends in normal walking, your entire body weight rests on the bunion at each step. Bunions can be extremely painful. They're also vulnerable to excess pressure and friction from shoes and can lead to the development of calluses.
Bunions can be caused by the following factors. Hereditary (especially via the female line). Rolling in (pronation) of the feet. Walking with turned out feet. Weakness of muscles controlling the big toe. Weakness of intrinsic muscles of the feet. Leaning on the big toe in a tendu, especially to second or derri?re. Reduced mobility of the big toe when on demi-pointe. Restricted pointe range.
With Bunions, a person will have inflammation, swelling, and soreness on the side surface of the big toe. Corns most commonly are tender cone-shaped patches of dry skin on the top or side of the toes. Calluses will appear on high-pressure points of the foot as thick hardened patches of skin.
Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight. X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout , rheumatoid arthritis , or joint infection.
Non Surgical Treatment
Pain is the main reason that you seek treatment for bunion. Analgesics may help. Inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures. Anti-inflammatory medications may help. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and orthotics to off-load the bunion. As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal toe and foot joint range of motion and muscle length. Treatment may include joint mobilisation and alignment techniques, massage, muscle and joint stretches, taping, a bunion splint or orthotic. Your physiotherapist is an expert in the techniques that will work best for you. Your foot posture muscles are vital to correct the biomechanics that causing your bunion to deteriorate. Your physiotherapist will assess your foot posture muscles and prescribe the best exercises for you specific to your needs. During this stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their feet that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon or return to a labour-intensive activity. Your physiotherapist will tailor your rehabilitation to help you achieve your own functional goals. Bunions will deform further with no attention. Plus, the bunion pain associated does have a tendency to return. The main reason is biomechanical. In addition to your muscle control, your physiotherapist will assess your foot biomechanics and may recommend either a temporary off-the shelf orthotic or refer you to a podiatrist for custom made orthotics. You should avoid wearing high heel shoes and shoes with tight or angular toe boxes. Your physiotherapist will guide you.
If all nonsurgical measures fail to control the symptoms, then surgery may be suggested to treat the hallux valgus condition. Well over 100 surgical procedures exist to treat hallux valgus. The basic considerations in performing any surgical procedure for hallux valgus are to remove the bunion, to realign the bones that make up the big toe, to balance the muscles around the joint so the deformity does not return.
The simplest way to reduce your chance of developing foot bunion or bunionette problems is to wear good-fitting shoes. Avoid high heels as they push your feet forwards to the front of the shoe where they get squashed. Also avoid narrow fitting shoes, especially those that are pointed at the front with a narrow toe box as again, these place pressure through the toes pushing them inwards. Shoes should be comfortable and leave enough room for you to wiggle your toes. Remember, bunions rarely affect non-shoe wearing people. Exercising your feet can also help. By strengthening the foot muscles you can improve your foot position which can help reduce foot bunion problems. Simple exercises like picking up small objects with your toes can help.