What is a Bunion?
A bunion is a common foot deformity where the big toe leans toward the 2nd toe and the joint which involves the base of the big toe protrudes giving the appearance of a “bump” on the side of the foot. It could have some irregular growth of extra bone and/or inflammation of the soft tissue surrounding the joint making the “bump” appear even larger. This big toe malalignment can cause pain and difficulty wearing shoes. Eventually, bunions can lead to a painful stiff joint due to arthritis.
Bunions are typically progressive in that they usually start mild and eventually grow to be more severe. The big toe leans more and more toward the 2nd toe, which may eventually lie under or over the 2nd toe in severe cases. As the toe leans more towards the 2nd toe, the “bump” appears more prominent. In some cases, a bunion that causes pushing against the 2nd toe over time can lead to a permanently dislocated 2nd toe. These deformities can become more and more stiff and permanently fixed in the adapted position.
Causes
Tight-fitting shoes do NOT cause bunions. This was used to be a common theory. Bunions are likely caused by genetics. You can inherit a foot type, which has instability within the foot joints making someone more prone to certain deformities. In theory, if this instability is not properly supported, a deformity can occur such as a bunion.
If a bunion deformity is present, then yes, tight-fitting shoes can be painful. It may even worsen the pain only because the big toe is being pushed into the smaller toes therefore crowding them as well as the extra pressure on the “bump.” Tight-fitting shoes forces the big toe to be held in a maximum bunion position making long-term adaptation easier for an already unstable joint and foot.
Symptoms
Many people have bunions that are asymptomatic. If a bunion does have discomfort, these are the typical complaints:
- Pain or soreness at the bunion “bump” and/or joint
- Pain or soreness in the bunion area after running or other activity
- A “dull” ache deep inside the joint area with big toe flexion and extension (like a “dull tooth ache”)
- Inflammation and redness especially after wearing shoes
- A burning sensation at the bunion “bump” which can extend to the big toe
- Possible numbness of the bunion “bump” which can extend to the big toe
- 2nd and sometimes even 3rd, 4th and 5th toe malalignment and dislocation
- Pain under the ball of the foot
Bunion discomfort is often experienced while wearing tight-fitting shoes and prolonged activities such as standing, walking and running.
Diagnosis
Most people know when they have a bunion because the bunion “bump” is visible. It is usually painful in shoes and in severe cases, hard to fit into normal shoes. What is important in the diagnosis is for a doctor to evaluate the bunion on x-ray to assess the joint and potential arthritis. An x-ray can reveal the severity and possibly the prognosis of a bunion deformity. Remember, because bunions are progressive, they typically will worsen over time. There is no “cure” for bunions but there are ways to help limit the discomfort, support the unstable foot and theoretically try to help any progression of the deformity.
For more information, contact us at Olympic Foot and Ankle at 916.244.7630.