Bunion is a large bony bump by the side of the big toe. It is often associated with
deviation of the big toe sideward.
What causes a bunion?
- Genetic: About 68% of people have it in families.
- Narrow and high heeled footwear: Possibly one reason why it is more common in ladies.
- Rheumatoid arthritis: This arthritis has a tendency to cause bunion
along with other foot problems like hammer toes, forefoot pain, heel pain etc.
How do you diagnose a bunion?
Your doctor will probably look for the following:
- Pain on the inside of the foot at the
junction of forefoot and big toe.
- Swelling at the same area.
- Deviation towards the other toes.
- Pain under the ball of the second
- You may not have all or any of the symptoms described above, but you might be concerned about the look (cosmetic) of it and might still want to see the doctor.
Tests for bunion:
- Your doctor might order an x ray of
the foot in two views
- X rays throw valuable information on the amount of deviation
- of the big toe and how much that joint is arthritic
- All this information is useful in planning for
the best treatment.
Treatment of bunion:
Both surgical and non-surgical options exist for treating a bunion and are used at the discretion of the treating doctor based on clinical grounds.
Non-surgical treatment of bunion:
- A bunion splint helps to keep the big toe away from the other toes and is effective when used early in the disease
- A soft toe spacer also helps to keepthe 1 st and the second toe apart.
- Because forefoot pain and corns are a common problem associated with a bunion, soft insoles are also prescribed in some cases.
- Anti-inflammatory medicines.
- Shoes with extra depth and width should be worn. If unavailable then they should be custom made.
Surgical treatment of bunion:
- Removal of the bump, releasing the tight muscle pulling the big toe inward and re-aligning the 1 st ray ( the part behind the I st toe) with an operation called scarf osteotomy is the cornerstone of treatment.
- Post-operatively a walking slipper for 6 weeks should prevent any recurrence of the deformity.
- Rarely with a very arthritic toe joint, a joint fusion and angular correction as described above, is done.
- In the elderly, removing the arthritic joint ( called excision arthroplasty) is another option. This relieves the
pain but can cause a weak push off when walking.