Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
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
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-counterarch supports, orthotics, and
taping by a physical therapist or doctor. Surgery is an option when
conservative treatment fails and you have chronic pain.
Bunions involve enlargement and repositioning of
joints at the ball of the foot.
Bunions most commonly affect the inner foot but also can affect the outside of the foot at the base of the little toe.
Bunions most commonly affect women.
Bunions may or may not cause symptoms.
Treatment of bunions can include rest, alteration of
footwear, foot supports, medications, and/or
surgery.
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 misalignment causes the big toe to move outward (medically termed hallux valgus deformity). 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, or MTP 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.. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed
shoes, might increase the risk for bunion formation. Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. While the precise causes are not known, there also seems to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals.
Picture of a bunion. SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
Other risk factors for the development of bunions include abnormal formation of the bones of the foot at birth (congenital), nerve conditions that affect the foot,
rheumatoid arthritis, and injury to the foot.
Bunions
are common in ballet dancers.
What are symptoms and signs of a bunion?
Bunions may or may not cause symptoms. A
frequent symptom is foot 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. It is important to note that, in post-pubertal men and post-menopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that is similar to the pain caused by bunions.
Diabetes-related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
What is the operation (procedure) that is recommended?
Ask your surgeon for a
simplified explanation of the type of operation, technique
used, and reasons it should be performed. (Pictures and drawings can tell
patients and family a great
deal.) Why was this specific procedure chosen over possible alternatives?
What is the surgeon's experience with this procedure?
Ask the surgeon about his/her experience with this
procedure, its outcome, and the hospital or setting in which the operation will
be performed. Is the nursing staff accustomed to caring for patients who have had this procedure?
What is the reason that this procedure is necessary at this time?
Is the procedure being done to relieve pain, diagnose a
condition, correct
deformity, for cosmetic reasons, or what exact purposes? Must the procedure be
performed immediately?
