Working With A Bunion

posted on 19 Jun 2015 10:12 by kurt3flowers4
Overview
Bunions Hard Skin A bunion is a bony growth in the lower joint of your big toe. It usually forms where the big toe pushes over against the second toe, forcing the joint to stick out. As a weight-bearing joint, this can be extremely painful. Calluses and blisters can form on the edge of the bunion, doubling the pain. This crippling foot affliction usually gets worse with time. Surgery for bunions can be complicated, expensive, painful and does not guarantee a well-formed foot as the outcome.

Causes
High heels can exacerbate a potential bunion problem because they tip the body?s weight forward, forcing the toes into the front of the shoe. This may help to explain why bunions are 10 times more common in women than in men. People in occupations such as teaching and nursing, that involve a lot of standing and walking, are susceptible to bunions. Ballet dancers, whose feet suffer severe repetitive stress, are also amongst those who experience bunions. Women can sometimes develop bunions and other foot problems during pregnancy because hormonal changes loosen the ligaments and flatten the feet. Bunions are also associated with arthritis, which damages the cartilage within the joint.

Symptoms
No matter what stage your bunion is in, you can be in pain. Though bunions take years to develop, you can experience pain at any stage. Some people don?t have bunion pain at all. Pain from a bunion can be severe enough to keep you from walking comfortably in normal shoes. The skin and deeper tissue around the bunion also may become swollen or inflamed.

Diagnosis
Physical examination typically reveals a prominence on the inside (medial) aspect of the forefoot. This represents the bony prominence associated with the great toe joint ( the medial aspect of the first metatarsal head). The great toe is deviated to the outside (laterally) and often rotated slightly. This produces uncovering of the joint at the base of the big toe (first metatarsophalangeal joint subluxation). In mild and moderate bunions, this joint may be repositioned back to a neutral position (reduced) on physical examination. With increased deformity or arthritic changes in the first MTP joint, this joint cannot be fully reduced. Patients may also have a callus at the base of their second toe under their second metatarsal head in the sole of the forefoot. Bunions are often associated with a long second toe.

Non Surgical Treatment
A bunion may only need to be treated if it's severe and causing significant pain and discomfort. The different treatments for bunions are described below. If possible, non-surgical treatment for bunions will be used, which your GP can discuss with you. Non-surgical treatments can ease the pain and discomfort caused by a bunion, but they can't change the shape of your foot or prevent a bunion from getting worse over time. Non-surgical treatments include painkillers, bunion pads, orthotics, wearing suitable footwear, These are discussed in more detail below. If your bunion is painful, over-the-counter painkillers such as paracetamol or ibuprofen may be recommended.Bunion pads may also ease the pain of a bunion. Reusable bunion pads, made of either gel or fleece, are available over the counter from pharmacies. Some are adhesive and stick over the bunion, while others are held against your foot by a small loop that fits over your big toe. Bunion pads stop your foot rubbing on your shoe and relieve the pressure over the enlarged joint at the base of your big toe. Orthotics are placed inside your shoes to help realign the bones of your foot. They may help relieve the pressure on your bunion, which can ease the pain. However, there's little evidence that orthotics are effective in the long term. It's important that the orthotic fits properly, so you may want to seek advice from your GP or podiatrist (a specialist in diagnosing and treating foot conditions), who can suggest the best ones for you. Bunions Hard Skin

Surgical Treatment
There are many different procedures that have been described to correct bunions. The type of operation your foot surgeon recommends to correct your bunion should be dictated by the severity of your bunion deformity and the surgeon?s preference. There are well over 100 different bunion correction procedures described in the orthopaedic literature. However, the broad categories of bunion correction procedures are listed below. Removal of the medial eminence. Distal metatarsal osteotomy (chevron) with great toe soft-tissue tightening (medial capsular tightening and distal soft-tissue repair). Proximal metatarsal osteotomy Ludloff, Cresentic, SCARF, medial opening wedge) with with great toe soft-tissue tightening (medial capsular tightening and distal soft-tissue repair). Lapidus hallux valgus correction (first tarsometatarsal joint fusion) with distal soft tissue procedure. Great Toe Fusion (1st MTP joint arthrodesis). Akin osteotomy (Realignment bone cut at the base of the big toe). Removal of the medial eminence with suture stabilization of the first and second metatarsals. Keller joint arthroplasty (removal of the proximal aspect of the proximal phalanx).
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