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November 8, 2009
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Bunions

Medical Author: William C. Shiel Jr., MD, FACP, FACR

All of the women in my family have horrible bunions. Are there any exercises that can ward off or help bunions?

Author: Richard Weil, MEd, CDE
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Read about exercises that could prevent bunions.A bunion is an irregular bony prominence (a bump) on the joint where your big toe meets the main bones of your foot. The bunion causes the end of the big toe to bend toward the other toes and crowd them, while the bone at the base of the toe where it meets the foot moves outward beyond the normal limits of where the bone should be. Pain is caused by inflammation and the bone pressing against the shoe. Bunions are more common in women, as you report, and are caused by a number of reasons, including shoes that are too tight, years of abnormal motion (like dancers on point), poor foot mechanics, bone deformities, flat feet, and arthritis.

Treatment usually includes shoes with a roomy toe box (you should be able to wiggle your toes; the toe box should be wide enough to accommodate the bony prominence), padding, over-the-counter arch supports, orthotics, and taping by a physical therapist or doctor. Surgery is an option when conservative treatment fails and you have chronic pain.

What are bunions?

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The normal position of the big toe (straight forward) becomes outward-directed toward the smaller toes. The enlarged joint at the base of the big toe (the first metatarsophalangeal joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis) leading to additional swelling, redness, and pain.

A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion.

Who develops bunions?

Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women then men. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed, might increase the risk for bunion formation. Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. There also seem to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals.

Other risk factors for the development of bunions include congenital (present from birth) abnormal formation of the bones of the foot, nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.

What are symptoms of a bunion?

Bunions may or may not cause symptoms. A frequent symptom is pain in the involved area when walking or wearing shoes that is relieved by resting. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. This leads to intermittent or chronic pain at the base of the big toe.

Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness.



Next: How is a bunion diagnosed? »

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Bunions

Introduction

For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot problems.

How Can Diabetes Affect My Feet?

Diabetes can cause two problems that can affect your feet.

Diabetic neuropathy

Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of the foot may not function properly because the nerves that make the muscles work are damaged. This could cause the foot to not align properly and create too much pressure in one area of the foot. It is estimated that up to 10% of people will develop foot ulcers. Foot ulcers occur because of nerve damage and peripher...

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