Bunions (Hallux Valgus)

Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery by a podiatric physician is frequently recommended to correct the problem.

Causes, incidence, and risk factors

  • Bunions are more common in women and can sometimes run in families. People born with abnormal bones in their feet are more likely to form a bunion.
  • Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion.
  • The condition may become painful as the bump gets worse, and extra bone and a fluid-filled sac grow at the base of the big toe.

Symptoms

  • Red, calloused skin along the inside edge of the big toe
  • A bony bump at this site
  • Pain over the joint, which pressure from shoes makes worse
  • Big toe turned toward the other toes

Signs and tests

A doctor can usually diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.

Treatment

  • When a bunion first begins to develop, take good care of your feet.
  • Wear wide-toed shoes. This can often solve the problem and prevent you from needing more treatment.
  • Wear felt or foam pads on your foot to protect the bunion, or devices called spacers to separate the first and second toes. These are available at drugstores.
  • Try cutting a hole in a pair of old, comfortable shoes to wear around the house.

If the bunion gets worse and more painful, surgery to realign the toe and remove the bony bump (bunionectomy) can be effective. There are more than 100 different surgical procedures to treat this condition.

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