Bunions: What causes them and treatment options

A bunion is a bony bump on the joint at the base of the big toe.  The visible bump actually reflects changes in the bony framework of the front part of the foot.  With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead.  This throws the bones out of alignment, producing the bunion's "bump."  The tissues around the joint may be swollen and tender.  Bunions are a progressive disorder.  They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent.  Usually the symptoms of bunions appear at later stages, even though some people never even have symptoms.  Did you know that bunions don’t always have to be on the big toe? A bony bump at the base of the little toe is called a bunionette or tailor’s bunion. The little toe also bends inward, and the joint swells or enlarges.  

What causes a bunion?  

There are a number of reasons you can develop a bunion:  

• The way your foot is shaped puts too much pressure on your big toe joint. Because bunions can run in families, some experts believe that the inherited shape of the foot makes some people more likely to get them.
• Although wearing shoes that crowd the toes won't actually cause bunions in the first place, it sometimes makes the deformity get progressively worse. That means you may experience symptoms sooner.
• If you have flat feet, your muscles start to develop abnormal pull.  The foot muscles literally start bending your first toe in such a lever fashion at to cause a bunion. 

Symptoms associated?

You may have pain in your big toe, red or irritated skin over the bunion, and swelling at the base of the big toe. The big toe may point toward the other toes and cause problems in other toes, such as hammer toe. Spending long periods of time on your feet can also aggravate the symptoms of bunions. Women are most likely to have symptoms then men, because of the style of shoes woman tend to use. Like high-heels and shoes with a tight toe box.

How are they treated?

Currently, no strong evidence points to the best treatment for bunions. But in most cases, you can treat them at home. This includes taking medicine you can buy without a prescription to relieve toe pain. It also helps to wear shoes that do not hurt your feet. For example, avoid high heels or narrow shoes. You can wear pads like the bunion aid to cushion the bunion, which functions as a heel splint and in some cases, you can use custom-made shoe inserts (orthotics). And in severe cases surgery is an option. There are over 100 surgeries for bunions. Research does not indicate which type of surgery is best-surgery needs to be specific to your condition. The effectiveness of surgery for bunions has not been widely studied. It depends on the type of surgery, the surgeon's experience, and the severity of the deformity. It also depends on what you expect from surgery.