Treatment of Bunion (Hallux Abducto Valgus)
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Bunion is a bone bump, which forms on big toe. Bunion usually develops if a person has disturbed biomechanics of walking, during which his joint is bending and he is developing swelling on big toe. In orthopedics this disease is also known as Hallux valgus. Disease is fairly common among elderly. Its appearance indicates malfunction of muscles. Damage to muscle balance can also cause deflection of cones and toe. In this case, joint where the big toe is connected with foot curves in wrong position. That`s why there is inflammation and pain in the fingers. A similar problem may occur on the other side of foot. If bunion causes severe pain, a doctor may resolve to use injections of steroids or even surgery to solve the problem. There are two basic types of bunion - serous (non-infectious) and purulent (infectious) bunion. Symptoms of each of them are different and treatment of bunion depends on its type. 60% of people with bunion develop this disease after 60 years.
Number of deformities is directly proportional to age: up to 30 years, it occurs in three percent of people, and by 60 years risk rises to 16%. After 60, people are in the highest risk of developing bunion. According to Medical News Today, which is a medical journal, bunion can also appear in adolescent girls, aged 10-15. It can happen if they dance ballet professionally.
In most cases bunion forms as a result of congenital pathology of foot and toes, when joints become very weak. People who have flat feet are more likely to have this deformation. It can also be caused by arthritis, which is a disease that destroys bones. In some cases bunion is caused by injuries.
Many people believe that tight shoes are direct cause of bunion, but it was scientifically proved that this is not true. Tight shoes and high-heels can only aggravate and accelerate the process of developing disease. That`s why women who wear high heels very often and who have predisposition to this disease, are in higher risk of developing deformation. It happens because high heels create abnormal pressure on feet and friction that constantly rubs and weakens the bone of big toe. Skin responds to such pressure by forming a callus, that`s why soft tissue of foot becomes painful and inflamed. Ballerinas and other professional dancers are in higher risk of developing bunion, because they constantly need to stay on their toes, which means that toes take all the pressure created by weight of person. It can also be caused by rheumatoid, psoriatic arthropathy and cerebral palsy. In rare cases Sharot disease, multiple sclerosis and Down syndrome contribute to development of bunion.
- Pain in the big toe, especially when walking
- Skin and tissue surrounding deformity is red and swollen
- Area around the joint in very sensitive
- Burning in toes
- Wearing shoes becomes impossible
- Bump causes blisters
- Roughness of skin
Diagnosis of bunion is done during simple examination, when a doctor can ask a patient to walk for some period of time to see if there were any changes in gait. In most cases nagging pain in forefoot is caused by tight shoes and does not present any danger, as it can be solved by simple change of shoes to more comfortable.
Methods of bunion diagnostics include:
- Examination
- An X-ray
- A ultrasound of feet
- CT scan
- Magnetic resonance imaging
- Laboratory puncture, when a doctor examines liquid
- Arthrography, which is endoscopy of knee
- Blood tests for signs of inflammation
- Angiography of blood vessels to determine level of inflammation
- The most effective bunion treatment is minimally invasive bunion osteotomy, when doctor corrects a bunion. Before that patient needs to choose correct orthopedic footwear, which person will need to wear for one year or even more to support affected toe It is necessary to wear shoes with thick soles and rounded square front. They need to be low-heeled and have space. Such footwear can prevent skin from friction and reduce the pressure on affected joint.
- Bursectomy is the simplest and least complicated type of bunion surgery. A doctor removes bunion and, if necessary, hypertrophied portion of metatarsal bones. For this purpose, he needs to do incision, with which he removes excessive bone. A doctor can also perform surgery called osteotomy. He does a number of deep cuts at the thumb and underside of foot. After that he fixes toes bone tissue and primary metatarsal bone by metal structures. Purpose of this treatment is the reduction of formation. Bunion surgery recovery time is six to eight weeks, when a person needs to take extra care of his feet. It is also desirable to avoid moisture and exposure to water. In some cases, doctors prescribe a course of treatment with calcium after surgery to strengthen the muscles and to make them more fit in future.
- Injections into the affected joint help to reduce inflammation and fever. After such injections a person is recommended to have bed rest. Doctor usually uses corticosteroid injections into the joint area, which proved to be the most effective drugs for elimination of pain. In acute stage, doctor can prescribe analgesics and non-steroidal anti-inflammatory drugs, which include ibuprofen, indomethacin and diclofenac.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
