What Are The Main Causes Of Bunions?

posted on 19 Jun 2015 10:25 by kathlinelawford
Overview
Bunions Callous A bunion is a deformity of the big toe. A bunion is a toe that points at a sideways angle towards your second toe. There is also a characteristic bump on the inner side of the foot. As the bunion becomes more prominent, bunion pain can develop. The medical term for a foot bunion is hallux valgus.

Causes
Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arhritis or an injury produces a bunion. And some people are simply born ith extra bone near a toe joint. If you're at risk for developing a bunion, wearing high-heeled or poorly fitting shoes make the problem worse. As new bone grows, the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually, the inside tendons tighten, pulling the big toe farther out of alignment.

Symptoms
A bony bump along the edge of the foot, at the base of the big toe (adjacent to the ball of the foot) Redness and some swelling at or near the big toe joint. Deep dull pain in the big toe joint. Dull achy pain in the big toe joint after walking or a sharp pain while walking. The big toe is overlapping the second toe, resulting in redness, calluses, or other irritations such as corns.

Diagnosis
Physical examination typically reveals a prominence on the inside (medial) aspect of the forefoot. This represents the bony prominence associated with the great toe joint ( the medial aspect of the first metatarsal head). The great toe is deviated to the outside (laterally) and often rotated slightly. This produces uncovering of the joint at the base of the big toe (first metatarsophalangeal joint subluxation). In mild and moderate bunions, this joint may be repositioned back to a neutral position (reduced) on physical examination. With increased deformity or arthritic changes in the first MTP joint, this joint cannot be fully reduced. Patients may also have a callus at the base of their second toe under their second metatarsal head in the sole of the forefoot. Bunions are often associated with a long second toe.

Non Surgical Treatment
Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity. A podiatrist may recommend these treatments. Padding and Taping, Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain. Medication, Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammation caused by joint deformities. Physical Therapy, Often used to provide relief of the inflammation and bunion pain. Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement. Orthotics, Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity. Bunion Pain

Surgical Treatment
Depending on the severity of the deformity, this osteotomy can be done either at the end of the metatarsal (a distal osteotomy) or if the deformity is more severe, the osteotomy is performed at the base of the first metatarsal (a proximal osteotomy). One of the more common distal metatarsal osteotomies that is performed is called the chevron osteotomy. Typically a small screw is inserted into the bone to hold the metatarsal head in place and speed up bone healing. Following a chevron osteotomy, walking is permitted in a surgical shoe the next day after surgery and the shoe is worn for approximately three to four weeks before a more comfortable walking/running type shoe is worn.
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