Coping With A Bunion

posted on 14 Jun 2015 21:25 by rhodeskkbmnhakdh
Overview
Bunions A bunion or hallux valgus is a prominence on the inner border of the foot effecting the big toe and at the level of the 1st metatarso-phalangeal (MTP) joint. The bunion prominence which is seen and felt on the inner border of the foot is not due to any growth of bone but is due to the 1st metatarsal bone. With a bunion this has become more prominent than normal because the 1st metatarsal has moved away from its immediate neighbour the 2nd metatarsal. This widens the forefoot thus producing the bunion. An inevitability of the splaying of the foot which occurs with a bunion or hallux valgus is that the great toe itself is then pulled across in the opposite direction (towards the second toe) by the still normally located tendons of the big toe. A bunion or hallux valgus is commonly confused with hallux interphalangeus (where the deformity lies more distally and which tends to be less problematic). Here there is no increase in the space between the metatarsals, and the deformity lies in the shape of the phalynx bone.

Causes
Bunions are caused by pressure on the inside of the forefoot which causes the 1st metatarsal bone in the foot to migrating outwards. Biomechanical factors can contribute to the development of bunions for example if you over pronate where the foot rolls in or flattens excessively which causes the inside of the foot to rub against the shoe. Wearing high heeled shoes regularly also increases the risk of developing the condition . The pressure on the forefoot is increased considerably as the heel is raised up. Age is also a factor as the ligaments lose strength as you get older.

Symptoms
Bunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike, some bunions progress more rapidly than others. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.

Diagnosis
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI's are not usually required.

Non Surgical Treatment
Making sure that shoes don't press against the bunion worsening the pain is the first line of treatment. Protecting the bunion with felt or foam pads or devices to separate the first and second toes at night may be recommended as may cutting a hole in a pair of old, comfortable shoes to take the pressure off the bony protrusion. Nonsteroidal anti-inflammatory drugs may be recommended to help relieve toe pain. In rare cases, physicians may administer injections of corticosteroids to treat the inflamed bursa (fluid-filled sac located in a joint) sometimes seen with bunions. Custom orthotic devices are another option that may be beneficial in some cases. Bunions

Surgical Treatment
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

Prevention
Bunions often become painful if they are allowed to progress. But not all bunions progress. Many bunion problems can be managed without surgery. In general, bunions that are not painful do not need surgical correction. For this reason, orthopaedic surgeons do not recommend "preventive" surgery for bunions that do not hurt; with proper preventive care, they may never become a problem.
Tags: bunions