Sometimes, the big toe can become angled outwards towards the middle of the foot and second toe. This forces the top of the first metatarsal to stick out from the side of the foot at the base of the big toe. If this happens, the bones can become misaligned and a painful bunion can form. It is not known exactly what causes bunions, but wearing badly fitting shoes is thought to make the condition worse. Research also suggests that bunions may run in families. It is thought that bunions are more likely to occur in people who have unusually flexible joints, and that this flexibility may be inherited. In some cases, certain health conditions, such as rheumatoid arthritis and gout, may also be responsible for the formation of bunions. These conditions cause pain and inflammation in the joints.
The commonest cause of bunions is prolonged wearing of poorly designed shoes such as the narrow high heels that women wear. This is one of the reasons why bunions are much more common in women than in men. There is also a hereditary component to bunions in that many times we will see a grandmother, mother and daughter all with various stages of bunions. 38% of women in the United States wear shoes that are too small and 55% of women have some degree of bunion formation. Bunions are 9 times more common in women than they are in men.
SymptomsSymptoms include pain in and around the ball of the big toe, usually from the bone rubbing too much against the shoe. You may be unable to wear certain types of shoes due to the shape of the forefoot. The big toe appears to be bent inwards towards and in come cases over the inside toe.
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.
Non Surgical Treatment
Patients who suffer from bunions are usually referred to a surgeon. Unfortunately, surgery often makes the problem worse. Surgeons will use x-ray technology as a diagnostic tool, which does not always properly diagnose the pain source. Another problem with this approach is that it does not do anything to strengthen the weakened ligament in the foot and, thus, does not alleviate the chronic pain that people with this condition experience. Another standard practice of modern medicine is to use steroids or to prescribe anti-inflammatory medications. However, in the long run, these treatments do more damage than good. Cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, but both result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration. Plus, long-term use of these drugs can lead to other sources of chronic pain, allergies and leaky gut syndrome.
Surgery for bunions usually isn’t done unless you have already tried other treatment and it did not relieve your pain. Other treatment includes wearing shoes with lots of room for your toes and using pads and supports in your shoe for protection and comfort. Surgery may be right for you if your toe is too painful, if your bunion is very big, or if you can’t easily do your daily activities. It’s not clear how well bunion surgery works or which kind of surgery is best. How well the surgery works depends on how bad your bunion is, the type of surgery you have, and your surgeon’s experience. Your expectations will play a big role in how you feel about the results of surgery. If you want surgery mainly to improve the way your foot looks, you may be disappointed.