Causes and risk factors
The most common cause of bunions are wearing of narrow or tight shoes which causes compression on the bone resulting in an overgrowth. High heels shoes also trigger bunions; hence it is also commonly seen in women. People involved in occupations like teaching, ballet or salsa dancing, nurses where they need to stand for a prolonged period and where the activity can lead stress on the foot are vulnerable for bunions. Bunions can be seen in various types of arthritis like rheumatoid arthritis or gout. The increase weight and hormonal changes in pregnancy can also trigger formation of bunions. It is most of the times due to inherited foot types.
Clinical presentation:
Bunions are commonly seen on the sides of the big toes, either medially or lateral. It is usually seen at the base of the toe. The patient comes to the orthopedic with a complaint of palpable bump or overgrowth on toe. It is tender to touch and causes pain on walking. The patient complaints of burning sensation. Secondary infections of the bunions are common.
Investigations:
The symptoms narrated by the patient and the local examination of the foot carried out by the orthopedic doctor is sufficient to diagnoses the case. An X-ray of the foot is confirmatory investigations. Routine blood test and specialized blood test along with certain other investigations can be advised if the doctor suspects certain other underlying pathology. (E.g.: RA, gout)
Treatment:
Pains relieving medications or non steroidal anti inflammatory drugs are advised. Corticosteroid injections can be given. In cases where the conservative treatment fails surgical intervention is needed. Surgery aims at removal of the bunions. Certain modification like wearing of correct size shoes, placing padding’s or cushions on bunion areas or ice application for reducing the inflammation and pain needs to be implemented.
