BUNIONS

The joint at the base of the great toe is the most complex in the front of the foot. Here the bones, tendons and ligaments work together to transmit and distribute the body's weight, especially during movement. Should this joint become abnormally stressed over an extended period of time, a bunion deformity may result.

A bunion (from the Latin "bunion," meaning enlargement) is a protuberance of bone or tissue around the joint. The enlargement occurs either at the base of the great toe or on the outside of the foot, at the base of the little toe. This is called a "bunionette" or "tailor's bunion."

Bunions at the base of the great toe usually begin when the big toe starts moving toward the smaller toes (as when tight, pointed shoes are worn). This crowding puts pressure on the joint, pushing it outward. The movement of the joint in this outward direction starts the formation of a bunion.

A common deformity of the big toe joint, a bunion occurs mostly among people who wear shoes. Women are more frequently affected with bunions because of tight, pointed, confining or high heeled shoes. Wearing high heels is especially stressful on the joints of the foot because all of the body's weight rests there; the foot is then forced into a narrow, pointed toe box, compounding the problem. Older people are also vulnerable to bunions because of the higher incidence of arthritis affecting the big toe joint.

What causes a bunion?
A bunion is most often a symptom of faulty mechanics of the foot. The deformity does run in families; however, it is the foot type that is hereditary, not the bunion. People with flat feet or low arches seem more prone to develop the problem than those with higher arches.

A fracture or break in the joint may lead to arthritic changes and the development of bunion deformities with limited range of motion.Bunions may also be associated with various forms of arthritis. The arthritis can cause the joint's protective covering of cartilage to deteriorate, leaving the joint damaged with a decreased range of motion.

Symptoms
Pain from a bunion can be mild, moderate or severe, making it difficult to walk in normal shoes, especially those with high heels. The skin and deeper tissues around the bunion may also be swollen or inflamed. The other toes can be affected by a bunion, as a result of pressure from the great toe pushing inward toward the lesser toes. Toenails may begin to grow into the sides of the nail bed; the smaller toes can develop corns and become bent (hammer toes).

Treatment
Treatments for bunions vary depending on the severity of pain and deformity. In any case, evaluation by a podiatrist surgeon should be sought at the first sign of pain or discomfort, so that severe deformity can be avoided.

Courtesy of The Center for Podiatric Information


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