Victoria Beckham’s bunion woes have certainly contributed to raising awareness about this common foot deformity. The word “bunion” comes from the East Anglican word “bunny,” which means “small swelling.” A second origin can be traced to the Medieval French word “buigne,” which means “bump on the head.” A bunion is a lateral deviation of the big toe, with a bump on the inner side of the toe joint. A bump that develops on the fifth toe is called a “Tailor’s bunion,” or “bunionette."
What Causes Bunions
Also called “hallux valgus,” bunions have two interesting characteristics: they're 9 to 10 times more frequent in women than in men, and more common in people who wear shoes than in those who do not. For the above reasons, tight pointed-toed shoes are often blamed for bunion development. This happens because a tight toe box causes the big toe to push against the other toes. The resulting pressure forces the base of the big toe outward, away from the other toe bases, creating a bump. Sometimes, the big toe’s head ends up above or below the other toes.
Bunions often run in families. Additional causes include conditions that can affect the integrity and stability of the toe joint, or the muscles and tendons supporting it. Some examples are: a severe flatfoot deformity, chronic tightness of the Achilles tendon, muscle imbalance, weak feet and rheumatoid arthritis. Bunions are also more likely to form in persons who continually wear high-heel shoes.
Symptoms Associated with Bunions
Bunions are not always painful. However, with time, an untreated or growing bunion can lead to bursitis, which is an inflammation of the fluid-filled sac around the bone. This causes pain, and the body normally reacts by covering the swelling and the bone with a callus of thickened skin.
People with bunions often experience tenderness on affected toes. The big toe joint is very important because it supports the body and helps distribute weight during normal walking and daily activities. As a result, the bunion deformity and the associated pain often affect the way people walk, limiting their motion.
Self-Treatment of Bunions
The right kind of shoes is essential to bunion treatment. The proper shoes should have three important characteristics: they need to provide good foot support, have a toe box large enough to allow the big toe joint to flex, and be able to tightly hold the heel in place. Recommended shoe types include: boxed street shoes, sandals, athletic shoes, and soft leather shoes. Also, since feet tend to swell in the evening, buying shoes later in the day may give a more accurate idea of their true fit. If need be, a podiatrist or shoe store personnel can stretch a client’s shoes.
An important goal of bunion self-care is to relieve the pressure on bunion-affected toes. A number of over-the-counter solutions exist, including bunion shield pads, toe separators (placed on the bunions), as well as moleskin or gel-filled pads. Shoes should have enough room for the extra padding, while remaining comfortable. Additionally, Vaseline and some lamb's wool in one’s shoes can help alleviate friction blisters.
Another goal of self-treatment is to slow the progression of the bunion deformity. To that end, shoe inserts can help keep the foot in proper position during normal gait. Bunion splints or bunion slings are also used to keep deformed toes straight.
Inflammation causes pain. Solutions for painful bunions include Aspirin, ibuprofen, warm soaks, and ice packs. Note that, when using ice packs to lower inflammation, one should massage the bunion with strokes directed towards the body to promote blood flow to the heart.
Surgical Treatment of Bunions
Bunions result in permanent deformation. However, with rest, a change in shoes, foot supports, and medications, the discomfort they cause is usually tolerable. A bunionectomy, or surgical removal of a bunion, may be needed if home care fails and the pain affects normal function, or if an underlying deformity already exists. While bunions can re-occur even after bunion surgery, most procedures successfully remove the bunion bump, re-align the toe, and reduce the pain.
Resources
The Foot & Ankle Center of Washington
References
Current Diagnosis & Treatment in Orthopedics (4th Ed.), Jeffrey Mann, Steven Ross, & Loretta Chou; 2006:
Foot Care at Home, Michael A. Perrone, DPM; 2007
What to Do About Bunions; Dr. James P. Ioli, Harvard Women’s Health Watch, Feb 2004
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