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National Bunion Day
A bunion is a deformity of the foot involving the big toe joint. This is often painful and can cause a number of secondary problems.
The medical term for bunion is ‘hallux valgus’, and it affects around 23% of adults – women more than men. The big toe progressively deviates towards the lesser toes of the same foot, and the head of the metatarsal deviates in the opposite direction. This changes the angle of the joint and of course, its function.
It is important to raise awareness on National Bunion Day, as bunions are a very common foot problem. Bunions are progressive, meaning they will get worse without intervention, so it is important to seek professional advice before the condition becomes severe.
Genetic factors such as foot posture, hypermobile feet, length of metatarsal, and shape of metatarsal heads are believed to be the main causes. Although there are exacerbating factors such as footwear; heeled shoes transfer forces to the forefoot increasingly with increased heel height, and tight pointy shoes squeeze the toes together, encouraging the direction of deformity.
irst metatarsophalangeal joint (MTP joint / big toe joint) pain
This can be due to a number of causes such as: malalignment of the joint and cartilage, arthritic changes including limited motion, extra bone growth on the side of the joint creating an increased bump and pressure on the joint from footwear.
When the deformity is severe, the big toe can sweep across the foot and force other toes, typically the second toe, upwards into a hammered position. This can cause the proximal interphalangeal joint of the 2nd toe to rub on the top of the shoe creating a wound or corn.
When the first MTP joint does not function well, pressure is often transferred to, and increased at the 2nd MTP joint. This can cause several problems resulting in pain under this joint.
Bunion development gradually increases the overall width of the foot making it more difficult to find footwear to fit.
Treatments are usually divided into conservative, and surgical categories.
These include accommodating the foot, increasing comfort and reducing the rate of progression of deformity. This can be achieved with certain footwear and use of orthotic devices. Orthoses (inserts) can be custom made to address patient specific aspects of the foot, and to fit a particular style of shoe. Therapeutic injections can also be considered in conjunction with these. Conservative options can be useful to someone avoiding or putting off surgery.
Surgery is the only method of correcting the deformity, and has very good predictable outcomes. The method of surgery will depend on the patient and severity of the deformity.
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Thoughts and advice on foot health care from the Podogo team.