Bunions

A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus.

The deformity may gradually increase and may make it painful to wear shoes or walk. Anyone can get a bunion, but they are more common in women.

In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe.

A bunion forms when the bones that make up the MTP joint move out of alignment: the long metatarsal bone shifts toward the inside of the foot, and the phalanx bones of the big toe angle toward the second toe. The MTP joint gets larger and protrudes from the inside of the forefoot.

Bunions may be caused by:

• Wearing poorly fitting shoes—in particular, shoes with a narrow, pointed toe box that forces the toes into an unnatural position
• Heredity—some people inherit feet that are more likely to develop bunions due to their shape and structure
• Having an inflammatory condition, such as rheumatoid arthritis, or a neuromuscular condition, such as polio Imaging- X-rays can assess the alignment of your bones and further evaluate for conditions such as arthritis.

Bunionette

A bunionette, or "tailor's bunion," occurs on the outside of the foot near the base of the little toe. Although it is in a different spot on the foot, a bunionette is very much like a bunion. You may develop painful bursitis and a hard corn or callus over the bump.

Treatment

Nonsurgical Treatment
In most cases, bunions are treated without surgery. Although nonsurgical treatment cannot correct the deformity it can improve symptoms.

Shoewear changes to include a shoe with fits properly with a wide toe box is the main treatment. Icing and medication can also be helpful. Applying ice periodically can help with pain. Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help relieve pain and reduce swelling.

Surgical Treatment
Bunion surgery realigns bone, ligaments, tendons, and nerves so that the big toe can be brought back to its correct position. There are several surgical procedures to correct bunions.

Surgery to remove an adolescent bunion is not recommended unless the bunion causes extreme pain that does not improve with a change in footwear or addition of orthotics. If an adolescent has bunion surgery, particularly before reaching skeletal maturity, there is a strong chance the bunion will return.