Bunions are a common foot condition and are also known as hallux valgus. In technical terms it is a deformity of the first ray which can cause pain in the big toe joint. Or in layman’s terms it forms when the big toe starts to lean towards the other toes, causing the metatarsal bone to shift outward. Over time, this misalignment creates a prominent bump on the inner edge of the foot.
Bunions can be hereditary, or they may develop due to repeated pressure and friction on the foot. This can change the way we walk or people may find it difficult to find suitable footwear. Some people get a smaller bunion, known as a bunionette, in the joint of the smallest toe.
Several factors contribute to the development of bunions, including:
Many people have bunions without any symptoms and they usually develop slowly over many years.
Some people may find:
If you think you have a bunion, a Podiatrist will diagnose and assess the foot. Imaging such as x-ray may be undertaken to determine the severity and integrity of the joint.
Dependent on pain and whether conservative management of a painful bunion has helped, a Podiatrist may refer you to an orthopedic specialist.
When bunions cause pain or interfere with daily activities, it’s time to explore treatment options. Here are some common methods used to manage bunions:
To prevent bunions from getting worse, always choose comfortable, wide shoes that fit properly and don’t squeeze your toes together. It is particularly important to ensure you fit children’s feet with appropriate footwear.
There can be many other types of pain in the big-toe that can be confused for a bunion such as arthritis, gout and bursitis.
Arthritis can change the shape of the toe which can resemble a bunion due to swelling within the joint. This can cause hallux rigidus or limitus which causes bone spurs to develop within the joint. This leads to inflammation and irritation of the skin, making the bump resemble a bunion. Whilst the bony prominence is on the side in bunions, bone spurs with arthritis tend to occur above the big toe joint.
Gout occurs when there are high levels of uric acid which develop into internal crystals within the joint. This is a common problem which affects the toes and the feet, with the big toe being the most common site of pain. It causes the joint to become red, swollen and can be mistaken for bunions. The pain is sharp and intense and can decrease mobility. To reduce the pain medication can be issued and also consider a change to the diet.
Bursitis is a common cause of big toe pain and occurs where there is swelling and redness over the joint, often due to direct external pressure. Because the big toe tolerates the entire weight of the body when you walk it is prone to bursitis. It is also more susceptible to irritation from shoes. The bursa is between the bone and skin and this is where the inflammation sits, it can be incredibly painful. To help manage the pain, offloading, changing footwear and potentially anti-inflammatory medication or a cortisone injection is needed.
Have pain in the big toe joint
are finding it difficult to wear shoes, walk or do the activities you love.
Early intervention can make a significant difference in managing bunions and maintaining your mobility and comfort in the long run.
References: Mayo Clinic
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