Bunions and Lesser Toe Disorders
How easy it is to take our toes for granted. We simply expect that they will do their function. We rarely think about them, until they hurt.
Toes have extremely important functions. Like the rest of the foot, toes are complex structures. They help absorb our body weight and ground pressure when walking. They assist us with our balance and create the ‘push off’ movement as we walk. Consider the automatic function toes have when you wear ‘flip flops” and thongs.
Problems that affect the toes are generally caused by genetic abnormalities to the foot’s anatomy, injury, or inappropriate footwear. Bunions are one such resultant problem.
About Bunions
Bunions are an enlargement of the joint at the base of the large toe due to a change in bone structure. It creates a painful lump of bone on the outside of the joint that is progressively moving out of place. This forces the toe to bend in a direction it shouldn’t be facing. Hence bunions can be very painful, making it difficult to walk in shoes. An indicator of a potential bunion may be formation of callus on the outer edge of your big toe resulting from excessive rubbing and pressure in shoes.
The Tailor’s Bunion on 5th metatarsal joint, where it meets the pinkie toe, will usually result in the pinkie toe pressing against the 4th toes and sometimes curling under it. The bunion has a bump but it is smaller in size and referred to as a ’bunionettte”. It is usually the result of abnormal foot function, hypermobility of the joint or the outcome of an injury.
Hammer Toes (left) are abnormally shaped toes that pull back and upwards in relation to the norm. It is often more common in the 2nd toe. People with flat feet are prone to hammer toe, due to a change in muscle balances. Painful corns can form on top of the toe & tip of the toe. calluses on the ball of the foot may also form from the increased pressure in the area
Causes
Bunions are a progressive condition & begin very slowly over many years of abnormal motion and pressure on the joint, The Structural abnormalities that develop eventually lead to bunions, hammer toes and mallet toes, all of which are permanent changes to the toe’s appearance.
Possible causes are:
• Genetics— a foot type that is ‘bunion prone‘
• Abnormal foot biomechanics that cause excess foot pronation
• A poor walking style/gait
• Inflammatory disease (e.g. rheumatoid arthritis)
• Excessive use of inappropriate footwear such as high heels and shoes with tight toe boxes
Treatments
• Arthritic joints often appear bloated, swollen and take on a reddish tinge from ongoing irritation. These effects are irritated by protracted periods of rest or additional pain from moving. But all typify ankle, knee or foot arthritis. Stabbing acute pain in bunions is similar to gout.
• Pain may flare during physical exertion as activity causes joints to become tender and inflamed. Inflammation is the root cause of arthritic symptoms. Whilst incurable, arthritis can be managed and supported.
• Lengthy walking may cause pain to increase and spread through the leg hampering movement, making it difficult or impossible.
• Unfortunately though, the act of nursing the area and remaining still, will only worsen the condition.
• So, do something. Talk to your podiatrist for the growing range of treatment options that we have available and those we can show you have to continue to do at home.
Prevention
• Get shoes for your foot type. Avoid squeezing feet into ill-fitting shoes. Shoes must fit correctly the first time you wear them.
• Avoid excessive use of high heels and narrow or extremely pointed footwear
• Arrange for a Biomechanical Assessment with your podiatrist, especially if you have a history of bunions in the family. It provides valuable information about your biomechanical faults and allows your podiatrist to determine what can be done to support them. Preventative measures to minimize long term damage can then be put in place.
• Orthotic Therapy may help to align your feet correctly and minimize the progression of your bunions.
• Start early with your children. Have their feet seen by your podiatrist at a young age, so that their foot health history is monitored and action can be taken promptly, if or when necessary.
• Monitor feet for callus formation. Regular routine footcare, corn callus removal and nail care by your podiatrist is important and can significantly improve your quality of life.
Take the first step!