Bunions

What is a bunion?

Symptoms of bunions

Causes of bunions

Prevention / remedies / cures / treatment for bunions

References

What is a bunion?

A bunion (hallux abducto valgus) is a bony lump or enlargement that forms in the joint (metatarsal phalangeal joint) at the base of the big toe. The big toe points toward the other toes (lateral deviation) as the bunion progresses. The joint and surrounding tissue becomes inflamed and painful.

Occasionally bunions can also form at the joint at the base of the smallest (fifth) toe. They are called a tailor's bunion or bunionette.

Bunions can be accompanied by bursitis (inflammation of a small fluid-filled sac adjacent to the joint).

With an advanced bunion the big toe may be so deformed that it has to lie over or under the second toe. In this situation it hurts to walk or wear any kind of shoe.

About one in three people in most Western countries will get a bunion. They are about ten times more common in women than in men. Older people are more often affected than younger people, although bunions do occur in children with misaligned feet.

Bunions should not be confused with gout or arthritis, which can also cause inflammation, deformity and pain around the toes and feet.

Symptoms of bunions

• Pain in the toe joint and surrounding area. Painful to touch or press, and when walking.
• Growth of a bony lump (exostosis) at the side of the big toe joint.
• Irritated skin around the bunion. Redness. Thickening of overlying skin. Blisters may form more easily.
• Deformed bones, joints and ligaments as the big toe shifts towards the other toes. As the big toe shifts, its base becomes more prominent, forming the bunion. Eventually the big toe is forced to lie over, or more commonly under, the second toe. The second toe of patients who have bunions commonly forms a hammer toe.
• Trouble with shoes. It is difficult to find shoes that fit properly. Bunions may force you to buy a larger size shoe to accommodate the width the bunion creates. Eventually it hurts to wear any shoe, or even walk barefoot.

Causes of bunions

• Shoes. The primary cause of bunions is the long-term use of shoes, particularly tight-fitting shoes with pointed toes, or high heeled shoes. A study that examined people in cultures that do not wear shoes found no cases of bunions. (1)
• Genetic. People who have misaligned toes or feet, are flatfooted with feet that roll inwards (over pronation), excessive flexibility of ligaments, abnormal bone structure, or have mechanical instability in the big toe joint are more susceptible to bunions. This is especially common when bunions occur in children or young adults.
• Injuries or other trauma (sprains, fractures or nerve injuries), neuromuscular disorders (polio or Charcot-Marie-Tooth disease), or limb-length discrepancies (one leg longer than the other).
• Repetitive stresses to the foot. Bunions are common in ballet dancers and in a few sports.
• Arthritis.

Prevention / remedies / cures / treatment for bunions

A bunion is a progressive deformity and will get worse with time unless the underlying causes are treated. With treatment the prognosis can be excellent.

• Castor oil.
• Massage with (preferably) castor oil or olive oil.
• Foot and toe exercises.
  If these exercises cause pain, don't overdo them. Go as far as you can without causing pain that persists.
  This first exercise should not cause pain, but is great for stimulating blood and lymphatic circulation. Do it as often as you can every day. Only do this exercise after confirming it is OK with your doctor.
  Lie on your back and lift up your legs above you. Wiggle your toes and feet. Eventually you may be able to rapidly shake your feet for a minute at a time.
  Use your fingers to pull your big toe into proper alignment. Stretch your big toe and the rest of your toes. Curl them under for 10 seconds, then relax and let them point straight ahead for 10 seconds. Repeat several times. Do this at least once a day, and preferably several times.
  Flex your toes by pressing them against the floor or a wall until they are bent back. Hold them for 10 seconds, then release. Repeat several times. Grip with your toes. Practice picking up an article of clothing with your toes, dropping it, and then picking it up again.
• Warm water. Soak your feet for 20 minutes in a bowl of warm water. Try doing the foot exercises while soaking, and also relax and rest your feet.
• Epsom salts. Add it to your warm foot bath soak.
• Magnesium oil.
• Borax.
• Cold. Try an ice pack for bad flare-ups. Fill a plastic bag with ice and wrap it in a thin towel. Apply the ice pack for 20 minutes.
• Go barefoot whenever possible. Otherwise wear loose wide comfortable shoes or sandals.
• Tape your foot and toes into a normal alignment position. Your toes may adapt to the normal position after being taped for a week or two.
• A podiatrist can help with orthotic devices such as custom-made arch supports and shoe inserts. Shoe inserts help to realign your toes when you are wearing shoes. You can also buy bunion pads over-the-counter at pharmacies. If you catch your bunion in the early stages, a bunion pad may help to direct your toe back to the proper direction.
• Avoid activities that lead to bunions. Ballet dancing and many sports require constrictive shoes.
• Surgery is a last option for those with advanced and painful bunions that do not respond to any other treatment. The surgical operation to correct the deformity from a bunion is called a bunionectomy, which typically involves removing bony growth of the bunion, re-positioning ligaments and tendons, and realigning the bones of the toe joint. Surgery is usually a day procedure performed with a local anaesthetic. The bones may be stabilised in their new position with screws or pins. Hardware may even include absorbable pins that are broken down by the body after a few months. You can expect a 6 - 8 week recovery period during which crutches are usually required. Surgery is often successful but sometimes the big toe moves back to its previous deviated position. Proper footwear and orthotics reduces the chances of surgical failure.
• See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Samuel B. Shulman. Survey in China and India of feet that have never worn shoes. The Journal of the National Association of Chiropodists, 1949, Volume 49 1949 pp. 26-30.