About bunions (hallux valgus)

What is bunions (hallux valgus)?

Bunions facts

  • Bunions involve boney prominences and repositioning of the joints at the base of the big toes.
  • Bunions most commonly affect the inner foot at the base of the big toe but also can affect the outside of the foot at the base of the little toe, referred to as a bunionette or tailor's bunion.
  • Bunions most commonly affect women.
  • Bunions may or may not cause symptoms.
  • Treatment of bunions can include rest, icing, alteration offootwear, foot supports (orthotics), medications, steroid injections, and/or surgery.

What are bunions?

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents a misalignment of the big toe joint (metatarsal phalangeal joint) and, in some cases, additional bone formation. The misalignment causes the big toe to point outward (medically termed hallux valgus deformity) toward the smaller toes. This deformity is progressive and will increase with time. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint, or MTP joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. A more deep joint pain may occur as localized arthritis develops in later stages of the deformity.

A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion or bunionette.

What are the symptoms for bunions (hallux valgus)?

Other symp symptom was found in the bunions (hallux valgus) condition

Although bunions often require no medical treatment, see your doctor or a doctor who specializes in treating foot disorders (podiatrist or orthopedic foot specialist) if you have:

  • Ongoing big toe or foot pain
  • A visible bump on your big toe joint
  • Decreased movement of your big toe or foot
  • Difficulty finding shoes that fit properly because of a bunion

What are the causes for bunions (hallux valgus)?

There are many theories about how bunions develop, but the exact cause is unknown. Factors likely include:

  • Inherited foot type
  • Foot stress or injuries
  • Deformities present at birth

Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to the development of bunions.

Bunions might be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis.

What are the treatments for bunions (hallux valgus)?

Nonsurgical treatments such as rest and wearing loose (wider) shoes or sandals can often relieve the irritating pain of bunions. Walking shoes may have some advantages, for example, over high-heeled styles that pressure the sides of the foot.

Anti-inflammatory medications, such as acetylsalicylic acid (aspirin, Ecotrin), ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever) and naproxen (Anaprox, Naprelan, Naprosyn, Aleve), can help to ease inflammation as well as pain. Local cold-pack application is sometimes helpful as well.

To reduce tension on the inner part of the joint of a bunion, stretching exercises are sometimes prescribed. Depending on the structure of the foot and severity of the bunion, custom insole orthotics can slow the progression of the bunion and address underlying biomechanical causes.

Inflammation of the joint at the base of the big toe can often be relieved by a local injection of cortisone.

Any signs of skin breakdown or infection can require antibiotics.

When the measures above are effective in relieving symptoms, patients should avoid irritating the bunion again by optimizing footwear and foot care.

For those whose bunions cause persisting pain, a surgical operation is considered for correction of the bunion. The surgical operation to correct a bunion is referred to as a bunionectomy. Surgical procedures can correct deformity and relieve pain, leading to improved foot function. These procedures typically involve removing bony growth of the bunion while realigning the big toe joint. Surgery is often, but not always, successful; failure to relieve pain can result from the big toe moving back to its previous deviated position even after surgery. However, proper footwear and orthotics can reduce the chances of surgical failure.

What are the risk factors for bunions (hallux valgus)?

These factors might increase your risk of bunions:

  • High heels. Wearing high heels forces your toes into the front of your shoes, often crowding your toes.
  • Ill-fitting shoes. People who wear shoes that are too tight, too narrow or too pointed are more likely to develop bunions.
  • Rheumatoid arthritis. Having this inflammatory condition can make you more likely to develop bunions.
  • Heredity. The tendency to develop bunions might be the result of an inherited problem with the structure or anatomy of your foot.

Is there a cure/medications for bunions (hallux valgus)?

Bunions (hallux valgus), commonly known as bunions, is a complex deformity of the first ray of the forefoot. The underlying etiology is not fully understood. It is more common in women than men and is common in those who wear tight shoes or heels.

Treatments are of two types: conservative therapy and surgical treatments
1. Conservative therapy
It involves nonsurgical and trial-based methods. The techniques are not of defined effectiveness and do not correct the actual deformity. The goal is to manage the symptoms, and the methods are as follows:
-Shoe modification: Low-heeled, wide shoes.
-Orthoses: Improves alignment and support.
-Analgesics: Acetaminophen and NSAIDs to reduce pain
-Ice: Icing the inflamed deformity reduces inflammation.
-Medial bunion pads: To prevent irritation of HV deformity.
-Stretching: Eases joint mobility in the affected joint.
If the conservative therapy fails, surgical intervention is the only option. Intolerable pain and difficulty in ambulation are indications of the need for surgical intervention.
2. Surgical treatments
The goal of surgery is to correct the underlying deformity. Over 150 procedures have been described for the correction. However, they all involve one of the following approaches:
-Soft tissue procedures
Post-operative care depends on the type of procedure performed. Common movement restriction is better until sutures are removed. Long-term monitoring is required to ensure that deformity does not recur.

The chronic onset of sharp or deep pain,As HV deformity progresses, the frequency, duration, and severity of the pain gradually increase,Another relatively common presentation is tingling or burning pain at the dorsal part of the deformity,Other symptoms that affect patients include blisters, ulcerations, interdigital keratosis, and irritated skin adjacent to the deformity
A bony lump on the outside of the big toe

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