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| Bunion, Causes, Diagnosis, Treatment, Prevention, Complications |
A bunion is a gradually developing lump in the joint of the thumb or little toe. This condition occurs when the bone in the thumb or little toe bends against the finger next to it.
Bunions are characterized by a shift of the tip of the thumb or little toe toward the toe of the opposite foot. In a few years, this shift can result in the appearance of a lump in the joint that connects the big toe and the sole of the foot, which will become more and more obvious over time.
Bunions not only change the bone structure of the foot, but can also cause discomfort, pain, swelling or a red rash on the foot. Bumps that come out on the side of the thumb will also make it difficult for sufferers to wear shoes.
Although it usually occurs in the thumb joint, bunions can also occur in the little finger joint.
Bunion Type
Based on the toe affected and the age of the sufferer, bunions can be divided into several types, namely:
- Bunions, which are lumps experienced by adults and occur at the joint at the base of the thumb
- Tailor bunion or bunionette, which is a lump that occurs in the joint at the base of the little finger
- Congenital bunions, which are lumps that appear in babies from birth
- Juvenile bunions, which are lumps experienced by teenagers aged 10-15 years
Causes of Bunions
Bunions occur due to deformity of the joints at the base of the big toe or little toe. This condition makes the joint that connects the thumb or little finger bone with the foot bone shifts from its proper position.
This abnormality causes the joint to tilt to the side. As a result, the thumb or little finger bone is pushed and leans toward the finger next to it. Over time, the abnormality will increase in size, resulting in a lump.
The cause of this disorder is generally difficult to know. However, it is suspected that the following conditions can trigger bunions:
- Foot deformities that are inherited due to genetic factors, such as bone structure abnormalities, flat feet (flat feet), or connective tissue between bones (ligaments) that are too soft
- Foot deformity at birth
- Injury or pressure on the foot
In addition, there are also factors that can increase the risk of bunions, namely:
- Having a family member with bunions
- Having genetic disorders, such as Down syndrome and Ehlers-Danlos syndrome
- Suffering from neuromuscular disorders, such as cerebral palsy
- Wearing high heels that cause your toes to squeeze
- Wearing shoes that are too tight and narrow, or that are too pointy
- Suffering from rheumatoid arthritis or osteoarthritis
- Often standing for a long time
Symptoms of Bunions
The main symptom of a bunion is a prominent lump in the joint near the base of the toe. The lump may occur with or without other symptoms, which generally appear gradually as the bunion develops.
Some of the symptoms that may accompany are:
- Swelling in the joint of the thumb or little finger that makes the foot wider than normal
- Redness or stiffness around the base of the thumb
- Pain or burning sensation in the lump or forefoot
- Calluses or calluses, usually on the surface of the skin of the toes that rub against each other
- Hammer toe or changes in the shape of the toe
- Pain that occurs continuously or comes and goes
- Difficulty moving the thumb or little finger
- Difficulty walking
- The position of the thumb or little finger that looks tilted towards the finger next to it so that it can make the position of the two fingers crossed
When to go to the doctor
Although they generally do not require medical treatment, people with bunions need to see a doctor, especially if they are accompanied by more serious symptoms, such as:
- Pain in the thumb or toe that continues
- Visible lump in thumb joint
- Thumb or toe is getting harder to move
- Difficulty wearing shoes or finding the right shoes due to lumps
Bunion Diagnosis
The diagnosis of bunions begins with asking questions about the symptoms experienced, disease history, and the patient's overall health condition. After that, the doctor will examine the patient's physical carefully, especially in the legs. Generally, doctors can determine a bunion from the physical symptoms that appear.
On physical examination, the doctor will see firsthand the symptoms or signs that form on the patient's feet. The doctor will also ask the patient to move the thumb or little toe, to monitor the limitations of finger movement experienced.
To confirm the diagnosis, the doctor can ask the patient to undergo an X-ray examination, especially if there is a suspected abnormality in the shape of the bone or if the patient has had an injury to the leg. If needed, the doctor may also run blood tests to detect any inflammation in the joints that may be causing bunions.
If the bunion causes joint pain, swelling, and redness, the doctor will perform a joint aspiration. This action is done by taking a sample of joint fluid and examining it in a laboratory. The goal is to detect arthritis and gout.
Bunion Treatment
Treatment for bunions depends on their severity. To relieve excessive pressure and pain in the feet, doctors can use the following treatment methods:
- Give medicines to relieve pain, such as paracetamol, ibuprofen, or naproxen.
- Compressing the big toe with ice water, to help relieve swelling and inflammation in the big toe.
- Using medical aids in the form of pads, plasters/bandages, splints, or finger separators, to restore the position and angle of the thumb or little finger joint, and reduce pressure and pain caused.
If the above treatments are not able to overcome or relieve the bunion, then a surgical procedure may be required. The steps for bunion surgery are as follows:
- Lifting the tissue around the thumb or little toe that is the source of inflammation
- Straighten the position of the thumb or little finger by removing certain parts of the bone
- Reposition the bones of the toes back to their normal position as possible, as well as normalize the angle of the bones of the thumb or little finger that is problematic
- Unite the bones in the joint that is also inflamed
In addition to surgery, therapies such as massage, physical therapy, or ultrasound therapy may be used to break up soft tissue adhesions and relieve pain from inflammation.
Steroid injections may also be given to relieve pain and swelling. However, be aware that steroid injections can damage tissue if given too often or if injected directly into the joint.
Patients may be able to walk immediately after undergoing treatment. However, the recovery process generally takes several weeks or months.
Bunion Complications
Although rare, bunions are at risk for complications, such as:
- Bursitis, which is a condition caused by inflammation of the cushion around the joint (bursa)
- Metatarsalgia, which is inflammation and pain in the forefoot
- Hammertoe, which is a change in the shape of the toe, usually on the index finger, which bends with pressure and pain
Bunion Prevention
Because the exact cause of bunions is not known, there is no way to prevent it. However, there are several ways you can do to avoid the risk of bunions, namely:
- Wear shoes that match your foot size.
- Choose a shoe model that provides enough space for your toes, both in length and width.
- Choose a shoe material and shape that does not put pressure on the sole of the foot.
The above efforts can also be made to prevent recurrence in patients who have recovered from bunions.
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