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I think I'm developing a Bunion on my feet, what should I do?
13 سبتمبر 2014

د. Zakia Dimassi طب الأطفال
A bunion (scientific name hallux valgus or hallux abducto valgus) is a bump on the side of the big toe. If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.
The bump that you see reflects underlying deformities in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.” With a bunion, the base of the big toe (metatarsophalangeal joint) grows in size and sticks out. The skin over it may be red and tender. Wearing any type of shoe may precipitate pain. The larger the bunion, the more painful walking becomes.
A bunion typically results from repeatedly squeezing the feet into narrow, pointed-toe footwear and high heels. Too-tight shoes can also cause other disabling foot problems like corns, calluses and hammertoes. Of course, this does not happen to everyone – some people have familial predilection to develop bunions, because foot type (shape and structure) is hereditary, and some types are more prone to bunions than others. Low arches, flat feet, and loose joints and tendons all increase the risk. The shape of the metatarsal head (the top of the first metatarsal bone), if too round, it will make the joint less stable and more likely to deform when squeezed into shoes with narrow toes.
The joint that is most commonly affected by bunions has a crucial role in bearing and distributing weight during a range of activities. A bunion at this critical junction of bones, tendons, and ligaments can significantly impair the foot's functioning
- it can damage the other toes: under the pressure of the big toe, they may develop corns or become bent, forming hammertoes.
- The nails may become ingrown, and calluses may form on the bottom of the foot
- If you constantly shift your weight off the painful big toe joint to other metatarsals, you may develop discomfort in the ball of the foot.
Most bunions are treatable without surgery. Prevention is always best. To minimize your chances of developing a bunion, you need to follow these preventive measures:
• Choose shoes that have a wide toe box and let go of shoes with pointed toes or high heels which may aggravate the condition. Never force your foot into a shoe that doesn't fit. Avoid shoes that are short, tight or sharply pointed, and those with heels higher than 6 cm. If you already have a bunion, wear shoes that are roomy enough to avoid putting pressure on it.
• Place pads over the area of the bunion to minimize pain.
• Avoid activity that causes bunion pain, including standing for long periods of time.
• Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.
• Applying an ice pack several times a day helps reduce inflammation and pain.
• Injections of corticosteroids into the affected joint, though rarely resorted to, may be useful in treating the inflamed bursa (fluid-filled sac located around a joint) sometimes seen with bunions.
• Some cases may necessitate custom orthotic devices.

If non-surgical treatments fail to relieve symptoms, or when symptoms start to impair your daily activities, it’s time to discuss surgical options with a foot and ankle surgeon. A number of surgical procedures are available to treat bunions. The procedures aim to remove the “bump” of bone, correct the bone deformities structure, and correct soft tissue changes that may also have occurred. The goal of surgery is the reduction of pain.
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