A bunion is an enlargement and malalignment of the joint at the base of the big toe. The joint where the bunion occurs is the first metatarsophalangeal joint (MTP joint). When bunions develop and change the way the joint flexes, this not only alters the way we walk, but also affects they way the body’s weight is distributed on the feet. That change in the way weight is carried by the body may contribute to the painfulness of bunions.
There appears to be an inherited tendency to have bunions. They tend to be more common among women than men, and loose ligaments or rheumatoid arthritis can increase the chance of having them. Shoes that are short, tight, sharply pointed or extremely high-heeled may seriously aggravate any bunion tendency.
How Bunions Develop
Bunions cause problems with foot appearance and shoe wear. They are also painful. When a bunion is beginning to develop, the base of the big toe starts to become enlarged and protrude. The big toe itself begins to point toward the second toe and the bones supporting the toes spread apart increasing the width of the foot. In advanced cases, the second toe may rest over the big toe. Unless shoes are fitted for extra width, pain will result from rubbing on the enlarged base of the toe or from bursitis, which may develop due to inflammation and pressure over the joint.
As bunions get larger, greater deformity in the affected joint can cause increasing pain and arthritis. With advancing deformity, normal foot mechanics are altered. This change in weight distribution often causes numbness and tingling, as well as intense pain in the fatty pad behind the toes, and may also cause skin there to harden and thicken.
Wider shoes with broad toes and soft soles often provide considerable relief from bunion pain. Making sure there is no pressure on the ball of the foot can help avoid flare-ups of bursitis. However, many women can not wear the type of shoe required to relieve bunion pain in their places of work. Bunions can often become simply too painful to live with and may require surgical intervention. There are now several types of surgery and refined techniques that can alleviate bunion symptoms.
The decision regarding the most appropriate surgical approach will be based on your orthopedic surgeon’s examination of the foot and x-rays. The degree of correction that can be achieved varies. Generally bunion surgery involves realigning bone and soft tissue so that the big toe can resume its normal position. Almost all bunion surgery can be done on an outpatient basis, with no hospitalization.
Bunion surgery is for patients:
- Who are experiencing daily pain.
- For patients who have noticed the size and shape of their bunion continues to get larger.
- For patients that can no longer find shoes to fit due to the size of their bunion.
- For patients with angulation and deformity of the toes.