Thursday, February 17, 2011

What is a bunion?

Bunions or referred to by physicians hallux abducto valgus (HAV) is a common foot deformity. Patients with this condition complain of pain around their big toe when wearing certain shoes, especially snug fitting shoes, or during physical activities, such as walking or running.  Mild bunion deformities can be treated with conservative care such as pads or foot orthotics, however more severe deformities or bunions that do not respond to conservative care are treated surgically.  There are different causes to why bunions occur, many of which are unproven. Nonetheless, they are functionally debilitating and cosmetically deforming to most people. 
How a bunion looks:
The classic bunion deformity presents with a bump on the side of the big toe with the big toe positioned closer to the second toe. The bump on the side of the toe is an overgrowth of bone and inflamed tissue. People with bunions have pain on the side of their big toe. Some will have pain on the bottom of their foot also. However, most pain is associated with the big toe due to snug fitting shoe gear. Shoes with narrow toe boxes or shoes made out of stiff material such as leather will often irritate the site of the deformity. Shoe gear of this type often leads to constant rubbing and irritation that causes the bump on the side of the toe to become painful, swollen, and inflamed.  Usually, pain in the first toe as a whole is due to improper positioning of the big toe, causing poor foot biomechanics and ultimately resulting pain the first toe.
Exact cause:
The exact causes of bunion deformities are unknown. Some of the many etiologies of bunion foot deformities are: genetic disorders, history of shoe gear with a tight toe box, neuromuscular diseases, family history, and biomechanical foot problems. The two most common accepted causes by most physicians are history of shoe gear with a tight toe box and improper foot biomechanics. Shoes gear is thought to be the cause of bunion, because HAV deformities are most common in women. In addition, bunion foot deformities are not common in barefoot population and in historical time periods before snug fitting shoes. Improper foot biomechanics is the universal cause accepted by most doctors, because surgical repair of bunion deformities often requires the restoration of proper foot biomechanical to reduce the bunion deformity.
Early conservative care of bunions are often symptomatic treatment. Functional foot orthotics can be helpful in early conditions improving the biomechanics of the foot. Pads and other cushion devices are also helpful to prevent the toe from shoe irritation. However for moderate to severe bunions, surgery is the most often the only corrective process of repairing a bunion deformity. These deformities actually cause a remodeling of the joint leading to changes in the function of the joint. The surgical process of correcting a bone is breaking and repositioning the bone and correcting the muscle imbalance in the foot. 
Bunions are cosmetically and can be functionally debilitating foot deformities. HAV are not only common, but are very treatable. If you are suffering from a bunion see a podiatrist.