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A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the 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 (known as Hallux Varus). 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, which is known as Hallus Abducto Varus. Bunions can also lead to other toe deformities, such as hammertoe.

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.

Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. The structure of the foot, which is hereditary, predisposes a person to develope bunions over time. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. Improperly fitted shoes will hasten the formation of a bunion in one who is predisposed to develope a bunion. It is not uncommon to have a bunion in only one foot, thus leading one to believe that wearing improper shoes are only a part what causes bunions to form. It is estimated that bunions occur in 33 percent of the population in Western countries, and are more common in women.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

  • The use of 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 carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth.
  • Having your shoes spot-stretched to accomodate the bunion. This can be done at a shoe repair shop, and is usually quite affordable.
  • 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.

Surgical Treatment

None of the conservative measures listed above are designed to "fix" the bunion. They are geared more to relieving your symptoms. 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.

There are many different procedures used to correct the bunions, depending on the severity of the deformity. Generally speaking, the recovery for a mild bunion is easier on the patient than when a severe bunion is surgically corrected.