WHAT ARE BUNIONS?
By: Sara John, C.Ped (C)., C.Ped Tech (C)
Bunions are more than a beauty issue. They can grow and worsen over time causing pain and hinder mobility. It is otherwise called as hallux valgus – hallux means big toe and valgus means away from the midline of the body.
Tight narrow dress shoes with a constrictive toe box can cause the foot to begin to take the shape of the shoe and can trigger bunions. But that is not the only cause. Certain foot types are more prone to bunions than others, and so they run in families, as the shape and structure of the foot is hereditary. Arthritis, foot trauma, low arches, flat feet, and hypermobile joints are other risk factors.
The first joint of the foot helps bear and distribute weight during gait. When there is a painful bunion, the weight is shifted from the first MTP joint to other joints resulting in calluses on the bottom of the foot. The smaller toes can bend leading to hammertoes or claw toes. Blisters or small corns may develop on the top of the small toes.
The first metatarsal bone of the foot turns outward, and the big toe points inward toward the other toes causing the joint to project out. The big toe may also go under or over the other toes resulting in overlapping toes and ingrown toe nails.
Most shoes do not accommodate the protrusion on the side of the foot adding more pressure to the misaligned foot. The small fluid filled pads that cushion the bones near the joint can get inflamed resulting in bursitis. Eventually the joint becomes stiff and painful with limited movement of the big toe.
The common symptoms are signs of inflammation with redness, swelling, pain and soreness on the side of the affected joint. As a result of the pain, it is impossible to walk properly.
A bunionette or Tailor’s bunion is a smaller bump seen on the outside of the little toe joint, and is formed when the little toe moves inwards towards the other toes.
Nonsurgical treatment includes wearing properly fitted wide shoes with room to accommodate the bunion. Footwear with rocker sole can help limit movement through the big toe joint. Shoe modifications such as spot stretching can relieve pressure and rubbing. Orthotics can help distribute pressure evenly, and provide extra support, comfort and protection. Bunion splints, toe spacers and aligners can help with progression of the bunion.
