What are the other Names for this Condition? (Also known as/Synonyms)

• Hallux Valgus Deformity

What is Bunion? (Definition/Background Information)

• Bunion is a deformity of the forefoot, in which the joint at the base of the big toe is bent, giving rise to a bony bump. Sometimes, the hind foot and ankle is also involved. The condition is more common in women and middle-aged individuals
• Some reported risk factors for the condition are being overweight, flat-footed, having an injury to the foot, wearing narrow shoes, and having a family history of Bunion
• It is believed that the condition is caused by usage of footwear that is narrow at the forefoot, which always keeps the forefoot in a slightly bent position (with respect to the plane of the foot)
• Some symptoms of Bunion include a bony bump on the base of the big toe, along with pain and restricted movement of big toe. Complications of Bunion may include bursitis, hammertoe, and increasing pain and inflammation causing arthritis of the foot
• Bunions are treated by conservative measures, such as wearing proper footwear, padding and taping of foot in normal position, as well as pain medications. Cases that are resistant to conservative treatment may need surgical measures to correct the deformity
• Prognosis of Bunion is generally good and the condition responds well to treatment. Nevertheless, wearing the appropriate footwear is known to help prevent this condition

Who gets Bunion? (Age and Sex Distribution)

• Bunions usually occur in middle-aged adults aged 40 years or above
• The condition affects women more than men
• All racial and ethnic groups are at risk and no particular preference is observed

What are the Risk Factors for Bunion? (Predisposing Factors)

Risk factors associated with Bunion include:

• Wearing narrow and high-heeled footwear (especially in women)
• Being overweight
• Having flat feet (pes planus)
• Having a family history of the condition
• Wearing footwear of insufficient length (incorrect size): This occurs more frequently in children, when they grow and their footwear is not changed to fit their foot size accordingly
• Being an athlete (overworked feet)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Bunion? (Etiology)

Bunions are caused due to uneven distribution of pressure on the feet while bearing weight. This kind of uneven pressure-bearing occurs due to the following reasons:

• Use of high-heeled or narrow footwear
• Flat foot due to weak foot arch
• Foot injuries causing damage to the soft tissues and ligaments of the big toe leading to instability of the joint
• Congenital foot deformities (present since birth), such as due to Charcot-Marie-Tooth disease
• Polio

What are the Signs and Symptoms of Bunion?

The signs and symptoms of Bunions may include:

• Swelling or bony bump on the base and lateral aspect of the big toe that is painful to touch
• Skin thickening at the base of the big toe
• Corns or calluses between the big toe and second toe
• Persistent or intermittent pain
• Loss of function of the big toe

Occasionally, the base of the smallest toe (5th toe) can get Bunion deformity. This condition is known as Tailor’s Bunion or Bunionette.

How is Bunion Diagnosed?

The diagnosis of Bunions may involve the following exams:

• Clinical examination and evaluation of medical history
• X-ray of the foot to determine alignment of the toes, which is helpful for planning future surgery. An X-ray of the affected foot is also helpful to rule out arthritis and gout - conditions that show similar symptoms

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Bunion?

Potential complications in individuals with Bunions include:

• Bursitis: Inflammation of the fluid-filled sac (bursa) that cushions the bone, tendon, and muscle near the joint
• Increasing pain and inflammation of the affected toe (first toe) leading to arthritis
• Hammertoe: It commonly presents as swelling on the medial aspect of the big toe. When the big toe presses on the second toe for a long time, it creates deformity of the other 4 toes. This causes all the toes to crowd together, a condition known as hammer toe

How is Bunion Treated?

Bunions are treated through conservative methods or surgical measures depending on the severity of the condition.

The conservative management measures include:

• Changing footwear and wearing comfortable and roomy footwear
• Padding and taping of foot in the normal position
• Use of pain medications such as acetaminophen and ibuprofen
• Inserting pads in the shoes to distribute the weight more evenly
• Undertaking suitable treatment of arthritis (if any required)

Surgery is done for cases not responding to conservative management. Surgical procedures vary depending on the cause of the Bunions. Some surgical procedures that are employed include:

• Removing the swollen soft tissue
• Shortening the big toe bone
• Permanent fixing of the big toe joint

How can Bunion be Prevented?

Bunions can be mostly prevented by wearing appropriate footwear (correct size and shape to fit your feet). The following preventative factors may be considered:

• Avoid wearing narrow-toed, pointed, and high-heeled footwear for long durations
• Footwear in children, who generally outgrow their shoes quickly, must be regularly replaced with the correct sizes
• Individuals with flat feet are recommended to use footwear that support the arch, thus decreasing the occurrence of Bunions
• Individuals, who are obese or overweight, may try to reduce their weight

What is the Prognosis of Bunion? (Outcomes/Resolutions)

• In majority of cases, the prognosis for Bunion is excellent
• The condition respond well to treatment; individuals generally get better in about 8 weeks following surgical treatment (when provided)
• Recurrence can be prevented by wearing comfortable and roomy footwear

Additional and Relevant Useful Information for Bunion:

• A bunion removal procedure is the surgical removal of a bunion or a deformity in the bone and/or tissue, found at the joint of the big toe

The following article link will help you understand bunion removal surgical procedure:

http://www.dovemed.com/common-procedures/procedures-surgical/bunion-removal/