BUNION

General Information

DEFINITION--A bony protrusion from the outside edge of the joint at the base of the big (first) toe.

BODY PARTS INVOLVED--Great (big) toe.

SEX OR AGE MOST AFFECTED--Female adolescents and adults.

SIGNS & SYMPTOMS--

• An inward-turned great toe that may overlap the second--and sometimes the third--toe.
• Thickened skin over the bony protrusion at the base of the great toe.
• Fluid accumulation under the thickened skin (sometimes).
• Foot pain and stiffness.

CAUSES--Hallux valgus. The technical name for the big toe is hallux. If the big toe has grown or been forced into a position where it overlaps one or more of the other toes, that is called hallux valgus.

RISK INCREASES WITH

• Family history of foot abnormalities (inherited weakness in toe joints).
• Arthritis.
• Narrow-toed, high-heeled shoes that compress toes together.

HOW TO PREVENT

• Exercise daily to keep muscles of the feet and legs in good condition.
• Wear wide-toed shoes that fit well. Don't wear high heels or shoes without room for toes in their normal position.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of the foot.

APPROPRIATE HEALTH CARE

• Self-care in the early stages. This may prevent a bunion from worsening.
• Doctor's (orthopedist's or podiatrist's) treatment.
• Surgery to remove the overgrown tissue (bunion) and correct the position of the bones (see Bunion Removal in Surgery section).

POSSIBLE COMPLICATIONS

• Infection of the bunion, especially in persons with diabetes mellitus.
• Inflammation and arthritic changes in other joints caused by walking difficulty, which places abnormal stress on the foot, hip and spine.

PROBABLE OUTCOME--Usually curable with treatment and preventive measures to guard against recurrence.

How To Treat

GENERAL MEASURES--

• Before bedtime, separate the great toe from the others with a foam-rubber pad.
• Wear a thick, ring-shaped adhesive pad around and over the bunion.
• Use arch supports to relieve pressure on the bunion. These are available in shoe-repair shops.

MEDICATION--Medicine usually is not necessary for this disorder unless infection develops.

ACTIVITY--If surgery is necessary, resume your normal activities gradually afterward. Walk on your heels until the surgical site heals. Elevate the foot of the bed to reduce swelling.

DIET--No special diet.

Call Your Doctor If

• You have a bunion that is interfering with normal activities.
• Signs of infection, such as fever, heat, tenderness or pain, develop after treatment or surgery.