Bunions

A bunion is a deformity of the big toe or little toecaused by inflammation and repetitive trauma to the metatarsophalangeal joint at the base of the toe.  The bone undergoes localized enlargements on the side and top of the joint to resist excessive pressure. Without eliminating or controlling the cause, these inflammatory changes are progressive, developing over time.

What are Bunions?

An orthopedic condition, bunions are described as a lateral deviation most commonly affecting the big toe.  Excessive pressure on the joint forces the toe into a more medial position.  The result is a cosmetically ill-looking prominence on the outer edge of the toe.  The condition leads to an over-growth of the toe joint, causing over-crowding and inflammatory conditions by restricting the space for other toes within the confinement of one’s shoes.

Medically known as a valgus deformity of the abductor hallux, bunions are most commonly seen along the metatarsophalangeal joint of big toe or the little toe (which is commonly known as tailor’s bunion).  These are the two toes most affected primarily because they are in direct contact with the hard surface of one’s shoes.

Reportedly, this condition is ten times more common in females than in males.

Signs and Symptoms of Bunions:

Bunions are considered progressive, growing lesions that tend to become bigger and more problematic with time.

The classic features of bunions include:

·         formation of a bump on the outer edge of the toe that is covered by a hard, calloused skin;

·         the bony bump may be red or may have a normal skin color;

·         the affected toe is turned in on the other toes;

·         pain or tenderness and swelling which is aggravated after wearing a confining shoe;

·         unmanaged bunions are a site of potential trouble because the bump is subjected to an inflammatory reaction each time one wears a confining shoe for  a long period of time;

·         the bony prominence may also occasionally lead to a cystic fluid-filled swelling which is extremely painful and discomforting;

·         involvement of surrounding nerves can cause numbness or a tingling sensation in toes.

How do Bunions develop?

The primary pathophysiology is the varying degree of joint inflammation, bone over-growth and inflammation of soft tissue in the region of the joint. Due to constant pressure and misalignment of joint surfaces, the inflamed tissue and bone undergo hyperplasia and develop a hard thick skin (or callus) to offer more resistance against the hard surface of shoes. In long-standing cases, the joint re-aligns and pushes against adjacent toes, resulting in the characteristic valgus deformity of the affected toe joint.

The most common risk factors associated with the development of bunions include:

·         genetics  since the condition tends to run in families;

·         bio-mechanics and skeletal structure since bunions tend to appear more frequently in individuals who have bone defects of the foot;

·         persistent inflammation of soft tissues, bones and joints

·         ill-fitting shoes, especially shoes with a narrowed toe;

·         wearing high heels further aggravates the condition by diverting all the pressure onto the toes;

·         conditions such as arthritis which affect an individual’s gait.

Bunions are treated at Ace Physio using a variety of Physiotherapy and Chiropody techniques including:

Custom Orthotics Prescribed by our in house Chiropodist

Shockwave Therapy

Splinting or Taping

Laser Therapy

Joint Mobilizations

Bunion surgery carries a certain degree of risk.  Many people with mild to moderate bunions can be treated effectively using conservative methods.  To learn more about our treatment of Bunions call 416-900-6653 or book an appointment online at www.acephysio.ca