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Overview<br><br>A bunion is a bony bump that forms on the joint at the base of your big toe. A bunion forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. The skin over the bunion might be red and sore. Wearing tight, narrow shoes might cause bunions or might make them worse. Bunions can also develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis. Smaller bunions (bunionettes) also can develop on the joint of your little toes.<br><br>Causes<br>Shoes with narrow toes can trigger a bunion, but they?re not the underlying cause. Bunions run in families, because foot type (shape and structure) is hereditary, and some types are more prone to bunions than others. Low arches, flat feet, and loose joints and tendons all increase the risk. The shape of the metatarsal head (the top of the first metatarsal bone) also makes a difference: if it?s too round, the joint is less stable and more likely to deform when squeezed into shoes with narrow toes. <br>SymptomsBunions 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.<br><br>Diagnosis<br>Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.<br><br>Non Surgical Treatment<br>Bunion pain can be successfully managed in the vast majority of cases by switching to shoes that fit properly and don't compress the toes. Your orthopaedic surgeon can give you more information about proper shoe fit and the types of shoes that would be best for you. Follow these general points of shoe fit. Do not select shoes by the size marked inside the shoe. Sizes vary among shoe brands and styles. Judge the shoe by how it fits on your foot. Select a shoe that conforms as nearly as possible to the shape of your foot. Have your feet measured regularly. The size of your feet change as you grow older. Have both feet measured. Most people have one foot larger than the other. Fit to the [http://nickiemcgeeney.jimdo.com/2015/03/28/what-can-cause-heel-pain largest foot]. Fit at the end of the day when your feet are the largest. Stand during the fitting process and check that there is adequate space (3/8" to 1/2") for your longest toe at the end of each shoe. Make sure the ball of your foot fits well into the widest part (ball pocket) of the shoe. Do not purchase shoes that feel too tight, expecting them to "stretch" to fit. Your heel should fit comfortably in the shoe with a minimum amount of slippage. Walk in the shoe to make sure it fits and feels right. (Fashionable shoes can be comfortable.) Some shoes can be modified by stretching the areas that put pressure on your toes. Splints to reposition the big toe and orthotics (special shoe inserts shaped to your feet) also may relieve pain. For bunions caused by arthritis, medications can be prescribed to reduce pain and swelling.<br><br><br>Surgical Treatment<br>Your podiatrist can refer you to a podiatric surgeon who will evaluate the extent of the deformity. A podiatric surgeon can remove the bunion and realign the toe joint in an operation generally referred to as a bunionectomy. However, there are actually around 130 different operations that fall under this title, so don?t presume you?ll need the same type of surgery as that friend of a friend who couldn?t walk for 3 months.