The word bunion is a term known to the general population, but it is often not known exactly what it refers to and what disorders it includes.
The word bunion is associated with a more technical name: Hallux Valgus. Etymologically it refers to the first toe (Hallux) and an outward movement (Valgus), which comes to define the attitude of the big toe in this deformity.
The Bunions are common foot disorders and appear at any age. As time passes since they appear, the bunion evolves to extremes in which the first toe is mounted on the second, which makes it impossible to put on a conventional shoe.
Another technical name is Hallux Abductus Valgus, in which he introduces the term Abductus, which defines the approaching movement towards the mid-axis of the foot (which passes through the second toe).
A clarification to keep in mind is the correct terminology to name the toes. People sometimes think that toes are named after their neighbors’ fingers. The names thumb, index, middle, ring, or little finger cannot be translated to toes. In the foot the terminology is simpler, since the toe is named from the largest to the smallest as first toe, second toe, third toe, fourth toe and fifth toe.
Causes of bunions
The cause of bunions is surrounded by great controversy and ambiguity. Footwear has always been considered a fundamental cause of this deformity. Bunions have been associated with the use of high-heeled, narrow-toed shoes, and usually the person who suffers from it believes so.
Different studies demonstrated the higher incidence of this problem in Western countries compared to other cultures such as Asian or African. But starting in the 60s, new data were presented that differed from the previous ones in which people with bunions had been found even in cultures that did not use walking shoes, such as certain tribes of the Amazon rainforest. This fact, together with the appearance of Hallux Valgus in young people and in men who usually wear a shoe that is wider than women’s, raised doubts about the true role of footwear as a causative agent of this deformity.
The study of human gait falls within Biomechanics, a science that relates the physical principles adapted to the functioning of the muscles and joints of the foot. Also study the movements of the body and of course those that occur during the march of the person. There are certain alterations in the normal biomechanics of human gait that condition the appearance of Hallux Valgus.
These alterations in the way the person walks, together with poor footwear and physical activity that damages the foot, accelerate the appearance of this deformity.
Other causes that can cause bunion are:
- Alterations in the shape of the bones of the foot.
- Ligamentous laxities.
- Rheumatoid arthritis
- Arthrosis .
Each cause that causes Hallux Valgus has a different why and how.
- Normally Hallux Valgus is caused by a biomechanical alteration of the foot, that is, the foot walks poorly and this causes the displacement of the first toe to be facilitated, because the muscles that make the foot walk are not well balanced and This imbalance drags the first toe into abnormal positions while walking. The first toe is moved outward and turned (Abductus Valgus) and this position held for a long time and fixed by the use of incorrect footwear causes the bunion to begin to develop.
- The outward migration of the first toe causes the structures that hold it in its original position (tendons, ligaments) to overstretch, causing pain and inflammation. Hence, in the initial stages, bunions hurt a lot and appear very red and swollen. Once the toe has managed to overcome the resistance of the tendons and ligaments and if the cause of the deformity is still present, the bunion progressively becomes larger and becomes increasingly deviated. Paradoxically in this phase the bunion can be painless, creating only difficulties when putting on normal footwear, due to the fact that the foot has increased in width.
Other causes such as Rheumatoid Arthritis and Osteoarthritis , have a different process than the previous one.
- In these cases, the inflammation of the joints and nearby tissues causes the muscle tendons to move, so that the muscular action on the finger is altered, moving it outward and causing this deformity.
- The shoe also places the toe in this position, which can initiate the disease if any of the above factors are associated. What has been proven is that there are people who wear a narrow-toed shoe and do not have a bunion, and people who wear a wide-toe shoe that do. Therefore, footwear cannot be understood as a causal factor but rather an initiating or accelerating factor of the deformity, that is, it either helps the bunion to manifest earlier or accelerates its evolution by worsening the deformity.
Bunions can cause:
- Pain localized in the inflamed area, which exactly coincides with the bone growth (bunion) at the level of the joint.
- Pain in the sole of the foot that does not normally coincide with the affected joint. The pain travels to the second and third toes in the area of the sole of the foot, right at its joint with the second and third metatarsals respectively. The reason for this lies in the abnormal functioning of the first finger, which makes the weight that it has to bear is now supported by the second and third, causing their joints to become inflamed and painful.
- Joint redness
- Calluses and corns under the first toe, and often under the second and third.
- Increased width of the ball of the foot.
- Bony growth at the base of the first toe.
- Riding of the first finger on the second. The first toe is progressively mounted on the second, which causes an added problem in the latter with the appearance of calluses in the area that rubs the shoe.
How are they treated?
Keep in mind that to treat a bunion you have to know what causes it and of course treat it as well. In the initial stages and when the deformity is developing, it is important to treat the cause with an orthopedic insole that solves the problem of the foot when it walks. In addition, to reduce inflammation, anti-inflammatory drugs can be taken, always under the supervision of a health professional.
There are also digital separators, which separate the first and second fingers to prevent the movement of one over the other. These separators can be made of different materials and can be used during the day, using them when we are wearing shoes or at night, using them only while we sleep.
When the deformity is very large or causes a lot of pain, the only treatment alternative is surgery. There are different surgical techniques to treat bunions, and they consist of eliminating excessive bone growth and repositioning the finger in its original position. In podiatry techniques using local anesthesia are used in which only the area to be intervened on the foot is asleep and they do not need hospitalization, so it is possible to walk out of the operating room, thus facilitating a quick recovery and return to normal life.
Preventing the appearance of bunions is often a difficult task since many times the cause that causes it is an alteration in the shape of the foot that conditions an abnormal gait.
This condition can be hereditary and therefore cannot be prevented, but what can be done is to treat the problem of the structure of the foot that occurs in each case. For this reason it is very important that at an early age: children and adolescents go to a podiatrist to assess the condition of the foot and, if necessary, establish adequate orthopedic treatment. If we are able to correct this problem, we can avoid the appearance of bunions in the future.
Another way to prevent bunions from appearing is to wear correct footwear. It is important to wear footwear that has a wide and high toe box that avoids pressure on the fingers and that they are piled up one on top of the other. The heel of the footwear should not exceed 3-4 cm. since a high height increases the pressure on the ball of the foot, which collides with the toe of the shoe and deforms the toes.
You also have to take into account the use of excessively tight tights and stockings, which compress the tip of the foot and have a negative effect on the toes due to the fact that it crowds them and places them incorrectly to walk normally.
As in any pathology, early diagnosis is important, so when in doubt we must go to the podiatrist for resolution.
When to go to the podiatrist?
- Once a year during the child’s growth to assess the shape of the foot and its influence on the growth of the rest of the body.
- If I suffer from pain in the root of the first toe or if I have noticed sharp pricks and inflammation of this area
- If I suffer from bunions and I do not follow any treatment. – If I have noticed the beginning of the deformity and there is a history in my family of suffering from them.
To receive advice when choosing the most suitable footwear for my feet.
- Whenever you suspect that the foot is not working properly.
- When I want to treat my bunions with surgery.
- When I want to prevent my bunions from growing and getting worse.
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.