A bunion is a bony lump or projection that extends from the side of the big toe joint where it joins with the rest of the foot. If the bunion develops on the small toe it is known as a tailor bunion, or bunionette. Bunions are most common among people with specific inherited foot shapes and those who wear shoes that are very tight or constrictive in the toe area, as well as people who wear high heels on a regular basis. Bunions can make it difficult to find shoes that fit comfortably, and they can also be associated with significant pain when not promptly treated. Because they project from the side of the foot, bunions are often associated with blisters and calluses along the side of the toe joint.
Bunions develop when pressure against the big toe forces the top of the toe to lean in toward the other toes. Over time, this pressure causes the joint at the base of the toe to become stretched and strained, eventually pushing it out of its normal alignment and causing painful inflammation. Without care, the bunion can cause the big toe to cross over the neighboring toes, and it can also cause painful arthritis to develop in the joint, resulting in stiffness and immobility.
Bunion surgery involves a small incision over the toe joint to provide access to the joint so that it can be repositioned. A wire is often used to help the bones maintain a normal shape. Ligaments and tendons may also be repositioned, and in some cases, a portion of the bone may need to be removed. In other cases, portions of the joint will be removed or the joint may be fused to prevent pain.
When caught early enough, some bunions can be treated by switching to shoes that offer more room in the toe. Wearing special custom orthotics can also help by gently realigning the joint and supporting the joint to reduce inflammation and promote healing.
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