Do you have a lump on your big toe? Let's talk about this bunion (Hallux Valgus)!

Have you ever noticed a small bump -like bone protruding from the base of your big toe? You've probably experienced this yourself, or you've seen someone you know do. This is what we commonly call a 'bunion'. Let's talk about this in a little more detail today, because it affects so many people.

What is a bunion? What exactly is Hallux Valgus?

Simply put, a bunion is a bone spur that develops at the base of your big toe, the joint where the toe connects to the leg, medically known as the metatarsophalangeal joint (MTP joint) . It looks like a small ball-like bump. It most often develops on the inside of the big toe. Medically, we call this Hallux Valgus .

Imagine, your big toe is gradually pulled towards the other toes, and then that joint protrudes. That protrusion is called bunion.

If you feel like you have a lump like this on your big toe, especially if it's causing pain or numbness in your fingers, you should definitely see a doctor . Because it's easier to treat if it's caught early.

Are there different types of bunions?

Yes, there are actually several types of bunions. The most common type we see is the one that develops due to pressure on the big toe. However, bunions can also develop on other toes and for other reasons. Here are some of the types:

• Congenital Hallux Valgus: This may sound strange, but some babies are born with bunions. This is a condition that is present from birth.
• Juvenile or Adolescent Hallux Valgus: These are the types of bunions that occur in children and young adults under the age of 18. The condition can also occur at this age.
• Tailor's Bunion or Bunionette: This occurs at the base of your little toe . Don't be surprised by the name, it gets its name because tailors used to sit in the same position for hours at a time, causing their big toe to become compressed. This is often caused by wearing ill-fitting shoes or doing activities that push your big toe against the other toes.

How common is this condition called bunion?

This is actually more common than you might think. Research shows that in countries like the United States, about one in three people have bunions. This condition can also be seen in our country, especially among women and it can be seen to increase with age.

What are the symptoms of a bunion?

Often the biggest symptom is the lump at the base of the big toe. You can see it and feel it. In addition to that, there may be other symptoms such as:

• Pain or stiffness in the big toe. It may hurt just by standing or even when walking.
• There may be swelling and redness around the lump.
• Sometimes there is a change in color or redness .
• Inability to bend or move the big toe properly. Sometimes there may be a burning sensation when bending the toe.
• Difficulty putting on certain types of shoes , or increased pain while wearing shoes. This is especially noticeable when wearing narrow shoes in the front.
• Corns or calluses are thickened skin growths. These can develop on the bunion or between the toes.
• Hammertoes are a condition in which the joints and tendons of the toes are stiff and bent, resembling an Achilles tendon. The bunion can also cause the other toes to change shape.
• Numbness around the big toe.

Why do we get bunions?

It's really hard to say that there's just one reason why bunions develop. It can be a combination of several reasons . Think of it like a chain of interconnected events.

The main things that affect are:

• Family history: If someone in your family, such as your mother, father, grandmother, or grandfather, has bunions, you are more likely to develop them too. This is something that comes from genes.
• Abnormal bone structure: Some people are more prone to developing bunions because of the way their bones are arranged in their legs.
• Shoe choice: This is the most important factor and one that we can control. Especially for women, high heels and narrow toe boxes put a lot of pressure on the big toe, pushing it towards the other toes. If this happens for a long time, a bunion can develop.
• The way you walk (Foot mechanics): Your foot mechanics, that is, the way you place your foot on the ground, can also affect the way you put weight on your foot.
• Certain inflammatory conditions: For example, people with joint diseases like rheumatoid arthritis or lupus are at higher risk of developing bunions.
• Standing for long periods of time or doing jobs that put a lot of weight on your legs.

Simply put, your big toe joint is under constant pressure over a long period of time (perhaps years). What happens is that the pressure gradually pushes your joint forward and pulls it toward the other toes. Eventually, as your toe is stretched out like that, a lump forms on the MTP joint as your body tries to adjust.

Who is at higher risk of developing bunions?

Anyone can develop bunions, but some groups are at higher risk:

• For women: Women are more likely to develop bunions than men. Often, the tight, pointed-toe shoes that are worn in fashion can be a cause, right?
• Genetic influence : As mentioned earlier, if parents have bunions or other foot problems, their children may also have them. It has been found that more than 70% of people with bunions have parents who also have the condition.
• For those with previous leg injuries: People who frequently injure their legs, such as athletes, are also at higher risk.

Can a bunion cause other complications?

Yes, having a bunion can increase the risk of other conditions such as:

• Bursitis: This is when the fluid-filled sacs around the joints, called bursa, become inflamed and painful. When this occurs over a bunion, the pain becomes even worse.
• Hammertoes: Due to the extension of the big toe, the second and third toes may also be extended and bent like a hammer.
• Osteoarthritis: This means joint wear and tear. A bunion can cause the cartilage in the MTP joint to wear down, leading to arthritis.

How do you know for sure if you have a bunion?

A doctor will do a physical exam to determine if you have a bunion. He or she will look at your foot, feel your big toe, and ask you about your symptoms. You will need to be specific about how long you have had the bunion, what activities make it worse, and whether anyone in your family has the condition.

You may also need to see a podiatrist, a doctor who specializes in foot problems.

What tests are performed to diagnose bunion?

Most of the time, no major tests are needed to diagnose a bunion. However, your doctor may order X-rays to look at the position of the bones in your foot, how far your big toe is in relation to the other toes, and the condition of the MTP joint. X-rays are the only way to accurately assess the condition, especially if surgery is being considered.

What are the treatments for bunions?

Treatment for bunions depends on the level of pain you have, the size of the bunion, and how much it affects your daily life. Look, there are some things we can do ourselves.

• Change your shoes: This is the first thing to do. Switching to shoes with wide, deep toe boxes can reduce pressure on your toes. Avoid pointed, tight shoes. There are also stretching devices that can help you widen the shoes you already wear.
• Bunion pads and taping: Bunion pads, available at pharmacies, can be placed around the bunion to reduce pressure and friction from the shoe. Your doctor may recommend using medical tape to hold your toes in place.
• Orthotic devices: Orthotics are devices that are placed inside your shoes to provide support for your foot. These can be over-the-counter orthotics or custom-made inserts. Your doctor may also recommend that you place a small spacer between your big toe and your second toe. You may also need to use a splint to keep your big toe straight when you are not wearing shoes (especially at night).
• Pain relievers : Nonsteroidal anti-inflammatory drugs (NSAIDs) , such as ibuprofen , can help reduce pain and swelling. These can be taken as pills or as topical NSAIDs. But remember, don't take NSAIDs for more than 10 days at a time without medical advice.
• Ice: Applying an ice pack to the painful finger for 15-20 minutes several times a day can also provide relief. However, do not place the ice pack directly on the skin, but wrap it in a thin piece of cloth.
• Corticosteroid injections: If the swelling and pain are severe, your doctor may give you a corticosteroid injection into the bunion. These are prescription medications that quickly reduce inflammation .
• Physical therapy : You can work with a physical therapist to strengthen your leg muscles, increase joint mobility, and reduce pain. They can teach you exercises and stretches to help keep your toes in place.
• Surgery :If other treatments have not helped for months, or if the pain is so severe that you cannot walk or do your daily activities because of the bunion, your doctor may recommend bunion correction surgery . There are several types of surgery. Your doctor or surgeon will tell you the type of surgery you need and the details.

Do bunions get better on their own?

No, bunions do not heal on their own, and you cannot treat them on your own. A bunion is a change in the structure of the bones. To reverse it, you need medical help. If you have a bunion, be sure to see a doctor or a podiatrist. Only then can you be properly diagnosed and begin treatment that will relieve your symptoms.

Can a bunion be prevented?

Because bunions can develop for a variety of reasons (especially genetic factors), it's difficult to completely prevent them. However, wearing well-fitting shoes and adopting a lifestyle that's good for your feet can help slow down the development of bunions or prevent them from getting worse. In general, follow these tips to choose shoes that fit and are comfortable for your feet:

• Avoid wearing shoes that are too narrow, pointed, and high heels – especially if they pinch your toes. These are your biggest enemies!
• Even if you know your shoe size, try on several pairs of shoes to find the one that fits best . Because not all shoes come in the same size, from one brand to another.
• Before buying new shoes , try them on by sitting, standing, and walking around a bit . Check to see if your toes hurt, get pinched, or pinched in any way. There should be a little space between the shoe and your longest toe.
• You can find a more accurate fit by shopping for shoes at the end of the day , as your feet swell a bit throughout the day and are slightly larger in the evening than in the morning.

Your doctor or podiatrist can recommend the best shoe type or brand for your feet. If you have other structural foot problems, such as flat feet or high arches , ask your doctor if you need orthotics to prevent bunions.

What can someone with bunions expect?

Most people with bunions can manage their symptoms and live a normal life without much impact on their daily activities. Your doctor will work with you to find a combination of treatments that will relieve your symptoms and help keep your feet and toes healthy and strong.

The most important thing is, if you have symptoms of bunions, don't delay seeing a doctor.The sooner you start treatment, the better your chances of controlling your symptoms without the need for surgery.

People who have had bunion surgery can usually resume all their normal activities within two to three months , but it can take longer to fully recover.

When should I see a doctor?

If you notice any of these symptoms, see a doctor or podiatrist as soon as possible :

• Frequent pain in your legs or fingers.
• It's hard to walk or wiggle your fingers .
• A visible lump at the base of the big toe (whether it hurts or not).
• Swelling, redness, or warmth in or around the fingers.
• Numbness or loss of sensation in the fingers.

What questions should I ask my doctor?

When you meet with the doctor, you can ask questions like these to get a better understanding of the situation:

• Why did I get this bunion? Is it a problem with the shape of my foot?
• What kind of treatment is best for me? Will I need surgery?
• How long can we expect relief from these treatments?
• What can I do to prevent a bunion from developing on my other leg?
• Should I avoid wearing certain types of shoes altogether?
• What exercises can I do at home?

Finally, things to remember (Take-Home Message)

Bunions, or hallux valgus, are a common foot problem. They occur when your big toe is pushed out of its natural position, toward the other toes. Eventually, a bony bump can develop at the joint where your big toe connects to your foot.

If a bunion is causing you pain or interfering with your daily activities, it's important to seek treatment . It may be as simple as changing the type of shoes you wear, but to diagnose a bunion, you should see a doctor or podiatrist. Your doctor can then recommend treatments that will help relieve your symptoms and help you get back to the activities you love. It's best to seek advice as soon as possible, without delay!