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showBunion or hallux valgus is a common form of foot deformity. According to a study, 1 individual out of 3 above the age group of 65 years suffers from bunion to some extent [1]. It is more common in women compared to men.
Bunion is mainly caused due to structural changes in the big toe. The metatarsal bone becomes deformed and bends sideways, towards the opposite toe. Many people suffer from bunions with mild to almost zero symptoms without any pain. Some others, however, develop clear signs and symptoms of bunion like calloused skin, skin soreness, unstable feet, visible structural changes in the toe, etc.
If you have a bunion, it is necessary that you get the necessary medical support as soon as possible. This is because delayed treatment can lead to rapid progression of the structural deformity of your feet. Resultantly, the bunion can become immensely painful.
Here’s a quick glance at the symptoms, causes, complications, diagnosis, etc., of bunion.
Symptoms | Hard and calloused skin, skin sore on the bulges, changes in the shape of toe and feet, unstable feet |
Complications | Bursitis, central metatarsalgia, hammertoe deformity in the second toe, degenerations in the metatarsal head, MTP joint synovitis, entrapment of the dorsal cutaneous nerve, inflammation, osteoarthritis, nervous damage |
Causes | Genetics, ineffective connective tissues, short cold muscles, an Achilles’s tendon, joint disorders like rheumatoid arthritis |
Onset | Onset is not applicable for bunions |
Diagnosis | Physical examination and radiography |
Prevention | You can wear only flat and comfortable shoes and stay barefoot as much as possible to reduce the chances of developing a bunion |
Medication | NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) |
Here’s a detailed overview of Bunion – its symptoms, types, diagnosis, treatment and complications.
In a bunion, the physical structure of the foot gets hampered as a bony lump develops on the big toe. This happens because the first metatarsal bone bends sideways. It flexes towards the other foot.
Due to this deformed internal structure of the bone, individuals develop a bony bulge on their toes. The structural deformity will widen the front side of the affected foot. Patients may feel pain in their toes, especially on the bulging portion of their feet. This pain may cause difficulty in wearing shoes, especially if they are tight. Nevertheless, some individuals do not get any pain related to bunions, irrespective of the size of the bulges.
Following are some symptoms of a bunion you can witness [1], [2]:
As a result of these symptoms, it may become a difficult affair for you to find a pair of shoes that fits properly. Signs and symptoms of the bunion can worsen with time if you do not start treatment procedures.
Bunions can be hereditary and can pass on to children from their parents. Besides the inherited structural deformity, there are several factors that increase the risk of developing a bunion. These are as follows [1], [3]:
Many people believe that wearing uncomfortable and tight shoes, especially those with high heels, can also be a potential risk factor for this structural deformity of the bone. However, this is untrue and most people who wear such unfit shoes do not develop a bunion in their lifetime.
On the flip side, some others who always put on comfortable shoes may have feet with wider fronts or bunions. In this regard, you also need to know that, if you already have this medical condition and you wear uncomfortable shoes, your complication can worsen quickly.
The medical conditions caused due to bunion can be classified into two types, as mentioned below [4], [5]:
Furthermore, there are four stages, delineating the progress of deformity caused due to bunion. These are as mentioned below:
Stage 1: Sideways displacement of the hallux or big toe at the metatarsophalangeal or MTP joint
Stage 2: The big toe progresses towards or presses against the second toe
Stage 3: Widened intermetatarsal angle, related to the deformity of the second hammertoe
Stage 4: Complete or partial dislocation of hallux at the metatarsophalangeal joint
You can stop the stage-wise gradual progress of a bunion by getting treatment without any delay.
As stated, the bunion and its complications deteriorate with time. The angle between the phalanxes of the patient’s first toe may keep increasing in case of no medical interventions, even after the diagnosis. This is why you should ideally seek guidance from a certified Orthopaedics physician as early as possible. They will examine the progress of your bunion and advise you on which treatment procedure will be necessary for you. The doctor can also help you know which supporting medical instruments you should use and what self-care procedures you should ideally abide by.
You do not require undergoing many different diagnostic processes to know whether you have developed a bunion. Doctors can easily detect your deformity through physical examination and X-rays [1], [5].
The prognosis of a bunion depends on the treatment procedures. In case you have a non-severe bunion, your doctor will first go for the conservative processes of treatment. They may advise you to wear special shoes, do exercises for joint mobility, take analgesics, etc.
If your pain does not decrease, and your medical condition deteriorates even after conservative treatments, you may have to undergo a surgical process. After surgery, you may have to take post-surgical care for up to 12 weeks, depending on the type of surgery. There is also a likelihood of developing post-surgical complications like osseous non-union, numbness, hematoma, osteomyelitis, avascular necrosis, cellulitis, etc. [5].
Bunion is a progressive medical condition that deteriorates and complications develop over time. You need to start treatment to control the complications caused due to this deformity.
The treatments for bunions depend on several aspects such as symptoms, deformity, pre-existing medical conditions, etc. Considering all these factors, your doctor will advise one or more of the following treatment processes [1]:
As stated earlier, people generally develop bunions due to certain aspects, including family history or inheritance, and other medical conditions like rheumatoid arthritis. It will not be possible for you to control the inheritance-caused bunion.
Whatsoever, your doctor may advise the following steps to reduce the chances of developing and aggravating this medical condition [5]:
In case of an aggravated bunion, you can encounter complications like [5]:
The cost of treating a bunion is not fixed; rather, it depends on various factors including the types of the treatment process, the medical instruments you need to purchase to support your condition, etc. The session charges of doctors or clinics are also factors influencing the overall expenses of the bunion treatment. In case you need to undergo surgery to fix your misaligned metatarsal bone, your cost may be around Rs.2 Lakh to Rs.4 Lakh on average.
Bunion is a structural deformity of the foot that can develop in case the first metatarsal bone becomes misaligned and bends towards your opposite toe. In case you have a bunion, you can witness symptoms like skin soreness, calloused skin, bulges, widening of your feet, etc. You should take medical guidance at an early stage if you develop these symptoms. In case your bunion causes severe pain, you may have to get your misaligned metatarsal bone fixed through surgery.
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You can face the following challenges after the operation for your bunion completes: Your toe muscles can lose their strength and become stiffer The toe may not become completely straight even after an operation Your foot may still remain a little wide and as a result, you may have to wear comfortable and spacious shoes
You should wear shoes that have broad insteps, wide-toe boxes, and soft soles. If your medical condition is painful, you can choose a pair that has slight rockers at their bottom. You should ideally refrain from wearing shoes that are tight and short or have higher heels.
The symptoms of the following diseases can be similar to bunion: Septic joint Osteoarthrosis Hallux rigidus Freiberg disease Morton neuroma Gout Turf toe
You can wear the following orthopaedic instruments that will help you with your medical condition: Over-the-Counter Orthotics Shoes: You can wear these while walking Toe Spacers: You need to place it between the toes Splints: You can wear this orthopaedic instrument while sleeping to make sure that your big toe stays in a straight position
There are more than 150 different surgical procedures to treat bunions. Among the below are some of the most-used surgical options: Osteotomy Arthroplasty Arthrodesis Soft tissue procedures
https://www.ncbi.nlm.nih.gov/books/NBK513134/
https://www.nidirect.gov.uk/conditions/bunion
https://www.healthdirect.gov.au/bunions
https://www.sciencedirect.com/topics/nursing-and-health-professions/bunion
https://www.ncbi.nlm.nih.gov/books/NBK553092/
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