What is it?

A bunion is a shift of the toe bones into an improper position causing pain and loss of motion. The deformity involves the big toe and the first metatarsal. Gradually the first metatarsal moves toward the other foot while the big toe moves out of joint towards the second toe. Over time arthritis can develop in the joint due to mal-positioning. A bunion does tend to get worse over time.

Signs and Symptoms

• May/ may not be painful
• Usually painful over the bump with continued irritation and bruising to the bone from shoe wear and ground forces
• Pain on moving the joint of the big toe
• Inefficient gait due to imbalance of the first metatarsophalangeal joint and loss of range of motion (a rather important joint during walking for toe-off or pushing off the ground).

Causes

• Genetic deformity
• Imbalance of muscles and ligaments holding the first metatarsal in place
• Tight shoes and narrow shoes as well as high heels can worsen the condition

Treatment

Conservative Treatment

• Shoe modifications ( wider shoes)
• Simple insoles/ orthotics to control abnormal motion and slow progression of deformity

Surgical (Nail Wedge Resection)

• Surgery if conservative therapy doesn't help and is the only way to correct position and realign joint