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Bunion

(Hallux Valgus)

Definition

A bunion is a thickened lump at the base of the big toe. It is the result of the movement of the base of the big toe away from the smaller toes. At the same time, the top of the big toe moves toward the smaller toes. This instability creates metatarsophalangeal (MTP) joint inflammation and bursitis at the base of the big toe.
Bunion
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Causes

The exact cause of bunions is unknown, but it is likely a combination of genetics and environmental factors.

Risk Factors

Bunions are more common in women than in men. Other factors that may increase your chance of getting a bunion include:

Symptoms

Bunions may cause:
You should seek medical attention if you have diabetes and you are having problems with your feet.

Diagnosis

You will be asked about your symptoms and medical history. A foot exam will be done. An x-ray of your foot will be used to diagnose the bunion. It will also show the severity and amount of damage.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Supportive Care

It is important to relieve pressure on the bunion to stop progression of the deformity. This may include:
  • Padding the bunion to reduce pain
  • Taping the area to reduce stress and pain
  • Shoes that are wide and deep in the toe area to relieve pressure on the bunion
  • Shoe inserts to reduce symptoms and prevent worsening of the deformity
Prescription or over-the-counter medications and/or cortisone injections may be advised to reduce pain.

Physical Therapy

A physical therapist will assess the bunion. Ultrasound may be done to help relieve inflammation and pain.

Surgery

Surgery may be needed to relieve the pressure and repair the toe joint, if the other treatments fail. Surgical procedures include:
  • Removal of the bony lump
  • A more involved procedure to cut the bone and realign the joint

Prevention

To help reduce your chance of getting a bunion, take these steps:

RESOURCES

American Podiatric Medical Association http://www.apma.org

OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.org

CANADIAN RESOURCES

Ontario Podiatric Medical Association http://www.opma.ca

Health Canada http://www.hc-sc.gc.ca

References

Bunions. Ortho Info—American Academy of Orthopaedic Surgery website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00155. Updated February 2016. Accessed February 11, 2016.

Bunion surgery. Ortho Info—American Academy of Orthopaedic Surgery website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00140. Updated February 2016. Accessed February 11, 2016.

Ferrari J, Higgins JP, et al. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database of Syst Rev. 2004;CD000964.

Foot care. National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/foot-care. Updated December 22, 2015. Accessed February 11, 2016.

Hallux valgus and bunion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 14, 2015. Accessed February 11, 2016.

Maffulli N, Longo UG, Marinozzi A, Denaro V. Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull. 2011;97:149-167.

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