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Overview<br><br>The foot is made up of many small bones that sit perfectly together forming many joints. The big toe joint comprises of the first metatarsal and the proximal (close) phalanx of the toe. A bunion forms when base of the toe (first metatarsal) drifts away from the second metatarsal. The 1st metatarsal rotates and drops and so no longer sits in its correct alignment. The tip of the first toe then rotates and drifts inwards. Overtime, under the continuing stress of this altered position of the joint and the irritation that this causes, the joint can become inflamed.<br><br>Causes<br>A bunion is more common in women than men due to women wearing tighter fitting shoes. This condition can cause a variety of different soft tissue and bony complaints which may result in severe pain. <br>SymptomsWith an advanced bunion, the big toe joint can be significantly deformed.  The big toe can crowd the other toes and may lie over or under the second toe.  The larger the bunion gets, the more it hurts to walk. Wearing any type of shoe can be painful. Symptoms of bunions tend to increase over time as the condition worsens. Typical symptoms include deformity of the big toe joint. Growth of a bony lump (exostosis) at the side of the big toe joint. Pain, redness and tissue swelling (bursitis) over the big toe joint, with thickening of overlying skin. Pain when walking (particularly during the "push off" phase). Overlapping of the big toe above or below the second toe in severe cases.<br><br>Diagnosis<br>Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.<br><br>Non Surgical Treatment<br>Long-term treatment of bunions must be directed towards re-balancing the foot, so that we no longer walk with our weight forced on to the inner border of the foot. This is accomplished by controlling and reducing pronation with the use of a high quality arch support or custom made orthotics. These devices comfortably re-balance the feet and overcome pronation. This reduces the abnormal weight forces on the big toe and its metatarsal head, allowing the feet to function normally. As a result, the deformity should not worsen, and the pain should gradually subside. If the foot is not re-balanced, the deformity and pain will become worse.<br><br><br>Surgical Treatment<br>Bunion surgery is most often done on an outpatient or day-surgery basis, usually with a local anesthetic technique called an ankle block. The surgery typically takes an hour or two to perform. Following your surgery, you will stay in the Recovery Room for several hours while the anesthetic wears off. For your safety, you will be required to have someone to drive you home. You should keep in mind that any surgery carries with it very small-but-possible risks of complications such as allergic reaction to anesthesia, bleeding and infection.<br><br>Prevention<br>Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family. Exercising your feet can strengthen them. Learn to pick up small objects, like a pencil or pebble, with your toes. Wear nike shoes that fit properly and don't cramp or pinch your toes. Women should avoid shoes with very high heels or pointed toes.