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Bunions

Definition

Bunions, referred to in the medical community as Hallux Valgus or Hallux Abducto Valgus (HAV), are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually caused by the big toe bone protruding towards the inside of the foot and the 1st long foot bone protruding outwards. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe causing a secondary overlapping/ under lapping problem. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly and causes footwear fitting problems. 

Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the 5th toe moving inwards, towards the other toes.

Cause

Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function particularly excessive pronation (may appear as flat feet), arthritis, and most commonly wearing improper footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion, while high heels increase imbalances in foot function (causing protonation) and excessive pressure over the 1st toe joint . Women who were such incorrect footwear are particularly prone to developing this condition. 

It is important for men and women to realize that wearing incorrect footwear, which are tapered in the toe area, provide no ankle or arch support and are too high at the heel level can cause bunions to develop or worsen to the point where surgery is necessary.

Treatment and Prevention

In the early stages of the formation of a bunion, soaking feet in warm water with over the counter pain relieving powders can provide temporary relief. The best way to alleviate the pain associated with bunions is to wear properly fitting shoes. Shoes designed with a high and wide toe box (toe area), wedged heel which is not too high, and arch support are recommended for people suffering from forefoot disorders, such as bunions. Shoes with rocker soles will unload pressure to the bunion area. Custom made orthotics prescribed by a podiatrist are also recommended to aid in function of the 1st joint, offload the joint, limit imbalances in foot function (when present) while also provide cushioning and support. 

Other conservative treatments include using forefoot products designed to accommodate and relieve bunions such as bunion shields, bunion night splints, and bunion bandages. These conservative treatments can limit the progression of the bunion formation and relieve pain. 

Due to the fact that a bunion may be hereditary, children whose parents or close relatives have a history of bunion problems should consult a podiatrist for a routine check-up for any foot function imbalances which may predispose bunion formation. Preventive measures are taken to treat such imbalances including advice on footwear, insoles or orthotics as required.

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