Bunion
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Bunion
A bunion is a common problem that occurs as an abnormal bony protuberance at the base of the big toe.[1] Bunions form when the big toe pushes up against the other toes thus forcing the big toe joint in the reverse direction away from normal profile of the foot. As time passes, the abnormal position enlarges the big toe joint, further crowding the other toes which causes pain.[2]
Epidemiology
Bunion deformity was found in 36% of the study population and commonly occurs in women and older individuals[3]
Causes
A bunion usually develops when the pressure of bearing and shifting the weight falls disproportionately on the joints and tendons in the feet. This pressure imbalance consequently makes the big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of the foot.[2] Bunions develop due to wearing of high-heeled or ill-fitting shoes, inherited foot type, foot injuries and congenital deformities.[2]
Symptoms
A person with bunion may or may not have a symptom. Most usual symptom is foot pain in the involved area during walking or wearing shoes that is relieved by resting. A bunion typically causes enlargement of the base of the big toe and is frequently associated with positioning of the big toe toward the smaller toes. An intermittent or chronic pain at the base of the big toe is usually experienced by the affected individual.
When there is marked pain, there may also be swelling of the soft tissues, redness, and local tenderness. In post-pubertal men and post-menopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that mimic pain caused by bunions.[4]
Diagnosis
A careful examination of the foot helps identify a bunion. Inquiry in the patient's history such as wearing ill-fitting shoes aids. An X-ray of the foot may help identify the cause and the severity of the condition.[2]
Treatment
Non-surgical treatment options include painkillers , orthotics such as insoles, bunion pads and toe spacers and modifying the footwear. If the toe joint is painful and inflamed, applying ice pack on the affected area several times per day is recommended to relieve pain and inflammation. The area should be wrapped first with cloth so that ice will not be in direct contact with skin. Surgery may also be done to correct a bunion.[5]
References:
- http://orthopedics.about.com/od/toeproblems/tp/bunions.htm
- http://www.mayoclinic.com/health/bunions/DS00309
- http://www.eurekalert.org/pub_releases/2011-02/w-pob022311.php
- http://www.medicinenet.com/bunions/article.htm
- http://www.nhs.uk/Conditions/Bunion/Pages/Treatment.aspx
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