What Is Hallux Valgus?

posted on 04 Jun 2015 16:17 by rodgersslldxqacxw
Overview
Bunion Pain Bunions are bony bumps that form on the side of the big toe joint or baby toe joint (these are commonly called ?bunionettes? or ?tailor?s bunions?). Bunions most commonly result from one or more of the following factors: genetics, faulty foot mechanics like over-pronation, and/or long periods of time spent in improperly fitting footwear. Bunions can start with audible clicking (called ?crepitus?) and/or stiffness in the affected joint which indicates that the joint surfaces are rubbing together improperly. This may progress to include inflammation, degeneration of the surfaces of the joint, deformity (including bone growth at the joint line and displacement of the toe) and ultimately, loss of range of motion in the joint.

Causes
Abnormality in foot function, particularly a pronated foot. This is probably the most important and common causative factor. Family history of bunions. Narrow toed dress shoes and high heels may contribute to the formation of a bunion. Rheumatoid and Psoriatic arthritis. Genetic and neuromuscular disease (eg. Down's,Ehler-Danlos and Marfan's syndromes) resulting in muscle imbalance. Limb length inequality can cause a bunion on the longer limb. Generalized laxity of the ligaments. Trauma to or surgery on the soft tissue structures around the great toe (first metatarsal-phalangeal) joint.

Symptoms
Bunions typically start out as a mild bump or outward bending of the big toe. Bunions at this stage are usually only a concern of appearance at this stage, and at this point they often don't hurt much. Over time, the ligaments that connect the bones of the toe stretch out, and the tendons attaching to the big toe gradually pull it farther and farther towards the second toe. Sometimes patients will find their first and second toes begin to press together too much, and they'll often get a painful corn between those toes. As the bunion progresses, the big toe may begin to ride on top of the second toe, or vice versa, creating a second deformity. Others will develop bump pain at the site of the bony enlargement on the side of the foot. A painful bursa may develop at that site. This is particularly true in tight shoes. Many patients also develop a painful callus beneath the foot. Capsulitis and other types of metatarsalgia may develop in the joints beneath these calluses, particularly in the second and third metatarsophalangeal joints (the joints in the ball of the foot). Over time, with the toe held in a crooked position for enough time, arthritis develops in the big toe joint. This will usually result in decreased range of motion of that joint (a condition known as "Hallux Limitis"), which as a result, often causes the patient to changes in the way a patient walks. Often the patient walks in an "out-toed", or duck-like, fashion, which very frequently causes secondary pain in the legs, knee, hip, and low back.

Diagnosis
A simple visual exam is all it will take for your doctor to determine whether you have a bunion. He or she may also ask you to move your big toe in order to ascertain your range of motion. Your doctor may also look for any inflammation, redness, or pain. X-rays can help your doctor determine the severity and cause of the bunion. Your doctor may also ask you questions about your footwear, the symptoms you are experiencing, and if other family members also suffer from the condition. All these factors will help him or her diagnose you properly.

Non Surgical Treatment
Most of the time, non-surgical (conservative) treatment can control the symptoms of a foot bunion or bunionette. These include. Appropriate Footwear, changing to wide fitting footwear reduces the pressure on the big toe and prevents shoes from rubbing on the bony lump. When possible, go barefoot Toe stretchers are a really simple way to reduce foot bunion pain. Toe Stretchers, wearing toe spaces that fit in-between the toes help to stretch the muscles and ligaments around the toes, improving the alignment and relieving pain. Find out more about how these work in the Toe Stretcher section. Painkillers, your doctor may prescribe or recommend over-the-counter medication to reduce the pain and inflammation. Foot bunion correctors can be worn in your shoe to help realign your foot if you suffer from foot bunions. Orthotics. There are a number of over-the-counter shoe inserts that can help relieve symptoms. Bunion correctors work by realigning the bones in your foot to reduce pressure on the affected toe. There are both day-time and night-time splints on the market, although the evidence of their effectiveness is lacking. Ice. Applying ice packs to the foot can help reduce pain and inflammation. Bunion pads help to reduce any friction on your big toe. Bunion Pads. You can also get protective foot cushions that sit over the skin to prevent the hallux abducto valgus rubbing on your shoes. Bunion Pain

Surgical Treatment
Larger bunions often require the surgeon to move the entire bone over (1st metatarsal). This is accomplished by a cut or fusion at the bottom of the bone. The former technique, is called the Lapidus bunionectomy. Additionally, the repositioned bone is held in place with one or two surgical screws.

Prevention
To minimize the chance of developing bunions, never force your feet into shoes that don?t fit. Choose a shoe that conforms to the shape of your foot. Opt for shoes with wider insteps, broad toes, and soft soles. Shoes that are short, tight, or sharply pointed should be avoided.
Tags: bunions