Are you suffering from a large bump on the side of your big toe? Perhaps you noticed that this bump started out fairly small but has gotten worse over time. You very likely have a bunion.
You may have wondered why you have bunions. Is it just bad luck or is something else going on.
Are Bunions Genetic?
Bunions are not hereditary, but the foot structure that often leads to them is. Most notable are flat feet, but foot injuries, neuromuscular problems, and pronated feet can also contribute to their formation. In addition, wearing shoes that are too tight, high heels, and shoes with a narrow toe box can all contribute to the progression of bunions. It is estimated that bunions occur in 33 percent of the population in Western countries..
How Do Bunions Form?
Bunions form when the big toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe.
The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists. Bunions can also lead to other toe deformities, such as hammertoe.
With a bunion you can see on X-ray that the big toe is moving towards the second toe. In addition, you'll notice the first metatarsal separates from the second metatarsal. Without any bone formation, a bump begins to form on the side of the joint.
In addition, the first segment of the great toe and the metatarsal behind it often become hypermobile. As this happens greater and greater separation occurs between the first and second metatarsal causing the toe to drift over.
Let's compare this to your hand. Unlike the great toe, mobility is necessary or you wouldn't be able to touch your thumb to your little finger. If you make a fist with your right hand you'll notice a bump where your thumb knuckle protrudes out. Unless you plan to write with your feet, you don't need that hypermobility.
The hypermobility comes from the tendency of the foot to pronate as mentioned earlier. It's this hypermobility that causes the great toe to drift over toward the smaller toes.
What Causes the Pain?
Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.
If you lived in a place where the weather is always warm bunions would not be much of an issue since you could accommodate them with a pair of sandals. In a place like Seattle this is a much bigger problem as we need shoes almost all year long. Unfortunately, most shoes are not designed to accommodate bunions.
Conservative Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is two-fold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to footwear designed to accommodate the bunion and not contribute toward its growth (see blog link below for more information).
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
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.
What Patients Are Saying About Bunion Surgery at the Foot and Ankle Center of Lake City
"I had both bunions removed with surgery and Dr. Berg did a fantastic job........more"
For more information about bunions and related problems
Call us today at 206-368-7000 for an appointment! You can also request an appointment online.