The original definition of a bunion was a bursa (a fluid-filled sac) on the side of the foot near the base of the big toe. The bursa was caused by a chronic friction of the patient’s first metatarsal bone (the bone to which the big toe attaches) and the shoe. Few people go by this definition any longer. Today most people consider a bunion to be the enlarged bone on the side of the foot that typically caused the bursa. Along with this bump, there is usually an associated mis-alignment of the big toe, with it leaning in towards the second toe. In medical jargon, the term for a bunion is “Hallux Abducto Valgus,” or “HAV” for short. Though the condition is really slightly different, it may also be known as “Hallux Valgus.” Bunions are usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly. This is usually a progressive problem, and can make it difficult to find shoes that fit. The condition is often quite uncomfortable, not only because of the pressure the shoes exert on the bump, but because of the other factors associated with bunions, which we shall discuss shortly.
There is much debate as to which is the major cause, but it is likely that your genetic makeup makes you more prone to a bunion or bunionette and that then wearing ill-fitting footwear causes them to develop. Studies have shown that in cultures where people don?t wear shoes but are habitually barefoot, there are very few cases of foot bunions indicating a strong correlation with shoe wear. They are more common in females, most likely due to choice of footwear.
SymptomsWith Bunions, a person will have inflammation, swelling, and soreness on the side surface of the big toe. Corns most commonly are tender cone-shaped patches of dry skin on the top or side of the toes. Calluses will appear on high-pressure points of the foot as thick hardened patches of skin.
When an x-ray of a bunion is taken, there is usually angulation between the first metatarsal bone and the bones of the big toe. There may also be angulation between the first and second metatarsal bones. These angular irregularities are the essence of most bunions. In general, surgery for bunions aims to correct such angular deformities.
Non Surgical Treatment
Bunions may be treated conservatively with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by an orthopedic surgeon or a podiatric surgeon, may be necessary if discomfort is severe enough or when correction of the deformity is desired. Orthotics are splints or regulators while conservative measures include various footwear like gelled toe spacers, bunion toes separators, bunion regulators, bunion splints and bunion cushions. There are a variety of available orthotics (or orthoses) including over-the-counter or off-the-shelf commercial products and as necessary, custom-molded orthotics that are generally prescribed medical devices.
Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results. Fewer than 10 percent of patients experience complications from bunion surgery. Possible complications can include infection, recurrence of the bunion, nerve damage, and continued pain. If complications occur, they are treatable but may affect the extent of your full recovery.
The best protection against developing bunions is to protect and care for your feet every day. Avoid tight and narrow-fitting shoes. Limit your use of high heels. Wear comfortable shoes with adequate space between your longest toe and the end of the shoe. Getting treatment for very flat or very high-arched feet (if you are experiencing symptoms) will give your feet the proper support and help maintain stability and balance.
Pronation is the natural act of the body spreading the impact of walking, jogging or running throughout the foot evenly. As the foot strikes the ground, the ankle naturally rolls inward absorbing the shock of the ground and mobilizing to the terrain. Overpronation is when the ankle of the foot rolls in past its normal 15? of inward rotation. The cause of this could be many things such as foot type, biomechanics, or compensation strategies. People with flat feet often, although not always, overpronate.
There has been some speculation as to whether arch height has an effect on pronation. After conducting a study at the Rose-Hulman Institute of Technology, Maggie Boozer suggests that people with higher arches tend to pronate to a greater degree. However, the generally accepted view by professionals is that the most pronation is present in those with lower arch heights. To complicate matters, one study done by Hylton Menz at the University of Western Sydney-Macarthur suggests that the methods for measuring arch height and determining whether someone is ?flat-footed? or ?high-arched? are unreliable. He says, ?For this reason, studies investigating the relationship between static arch height motion of the rearfoot have consistently found that such a classification system is a poor predictor of dynamic rearfoot function.
Over-Pronation may cause pain in the heel of the foot, the foot arch, under the ball of the foot, in the ankle, knee, hip or back. The symptoms may be localized to one particular area of the foot or may be experienced in any number of combinations. Standing for long periods of time, walking and running may become difficult due to the additional stress and/or discomfort accompanied with these activities. Upon Visual Inspection, when standing the heels of the foot lean inward and one or both of the knee caps may turn inward.
When you overpronate your foot rolls inwards causing the lower leg to rotate inwards too. It’s thought that this increases stress on the soft tissues of the lower leg causing pain and inflammation, or more commonly known as shin splints.
Non Surgical Treatment
Over-Pronation can be treated conservatively (non-surgical treatments) with over-the-counter orthotics. These orthotics should be designed with appropriate arch support and medial rearfoot posting to prevent the over-pronation. Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improperly fitting footwear can lead to additional foot problems.
Subtalar Arthroereisis. Primary benefit is that yje surgery is minimally invasive and fully reversible. the primary risk is a high chance of device displacement, generally not tolerated in adults.
An implant is pushed into the foot to block the excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% – 100%, depending on manufacturer.