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What Are The Principal Causes Of Bunions?

MagnoliaOlney7195096 2017.06.11 21:55 조회 수 : 17

Overview
Bunions Hard Skin
A bunion is enlargement of bone or tissue that develops at the joint that connects your big toe to your foot. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and good running socks. When the joint, called the metatarsophalangeal joint, or MTP joint, experiences abnormal, prolonged stress in terms of weight distribution or squeezing of the toes within the shoe, the result can be the deformity called a bunion. Generally, a bunion develops when, as a response to prolonged stress, your big toe begins bending toward your foot's smaller toes and puts pressure on your MTP joint, forcing it to bulge outward (the term "bunion" comes from the Latin word for "enlargement"). There is no "standard" bunion, however, but rather a complex range of joint, bone and tendon abnormalities that can cause variation in each bunion's make-up.

Causes
Hereditary and shoe gear are probably the most likely causes. Tight pointy shoes (and high heels) may promote the formation of a bunion. A bunion may develop rapidly or develop slowly over time. Some people have bunions in their teens while others only develop a bunion later in life. Bunions come in a variety of sizes - from small to severe. In some cases, the big toe may push against the second toe, and may result in pain and a hammer toe, or progress onto a severe disfiguring foot deformity. Depending on your overall health, symptoms and severity of the bunion, the condition may be treated conservatively and/or with surgery.
SymptomsThe most common symptoms associated with this condition are pain on the side of the foot. Shoes will typically aggravate bunions. Stiff leather shoes or shoes with a tapered toe box are the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other. On rare occasions, the joint itself can be acutely inflamed from the development of a sac of fluid over the bunion called a bursa. This is designed to protect and cushion the bone. However, it can become acutely inflamed, a condition referred to as bursitis.

Diagnosis
Clinical findings are usually specific. Acute circumferential intense pain, warmth, swelling, and redness suggest gouty arthritis (see Gout) or infectious arthritis (see Acute Infectious Arthritis), sometimes mandating examination of synovial fluid. If multiple joints are affected, gout or another systemic rheumatic disease should be considered. If clinical diagnosis of osteoarthritic synovitis is equivocal, x-rays are taken. Suggestive findings include joint space narrowing and bony spurs extending from the metatarsal head or sometimes from the base of the proximal phalanx. Periarticular erosions (Martel sign) seen on imaging studies suggest gout.

Non Surgical Treatment
There is no way to eliminate existing bunions except to have them surgically removed. There are nonsurgical measures you can take to alleviate the pain and prevent your bunions from increasing in severity, and for that reason it's important to see your doctor before they become a serious problem. The more extensive your bunions are, the less effective nonsurgical treatments are. On the other hand, most bunions can be dealt with without surgery through wearing roomier, low-heel shoes, padding and taping your feet, using medications for pain control, going to physical therapy to relieve inflammation and wearing orthotics in your shoes to correct mechanical problems. Bunions that are not causing pain generally aren't appropriate for surgery. Roomier shoes. You should seek out shoes that conform to the shape of your feet as much as possible and provide plenty of room in the toe box, ensuring that your toes are not pinched or squeezed. You should make sure that, while standing, there is a half inch of space for your longest toe at the end of each shoe. Make sure the ball of your foot fits comfortably in the widest part of the shoe. Feet normally swell during the course of the day, so shop for shoes at the end of the day, when your feet are at their largest. Don't be vain about your shoe size, sizes vary by brand, so concentrate on making certain your shoes are comfortable. Remember that your two feet are very likely to be different sizes and fit your shoe size to the larger foot. Low-heel shoes. High heels shift all your body weight onto your toes, increasing the pressure on your toes and their joints tremendously. Instead, wear shoes with low (less than two inches) or flat heels that fit your foot comfortably. Padding and Taping. Padding the bunion can minimize pain and allow you to walk more normally. Specially designed pads for this are available at most drugstores. Taping your foot can reduce stress and pain in it by helping it stay in a more normal position. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with pain and inflammation caused by your bunion. Cortisone injections may be prescribed for the same purpose. If your bunion is a consequence of arthritis in the MTP joint, your physician may prescribe medications for that. Physical Therapy. Ultrasound treatments and whirlpool baths can help reduce pain and inflammation in bunions and related tissues. Orthotics are shoe inserts that can help correct mechanical foot-motion problems to reduce pain and prevent worsening of your bunion. Other measures. Icing and elevating your foot when your bunion is painful may help. Having your shoes stretched at a shoe repair shop may help also.
Bunions Hard Skin

Surgical Treatment
There are a number of different surgical procedures used to treat bunions. The type of surgery recommended for you will depend on the severity of the deformity. Your surgeon may use pins, wires or screws to hold the bones in place while they heal. Depending on the type of surgery you have, these may be left in your foot or removed later on. Some of the surgical procedures for bunions are described below. Osteotomy is the most commonly used and proven type of bunion surgery. Although there are many different types of osteotomy, they generally involve cutting and removing part of the bone in your toe. During the procedure, your surgeon will remove the bony lump and realign the bones inside your big toe. They'll also move your toe joint back in line, which may involve removing other pieces of bone, possibly from the neighbouring toes. A procedure called distal soft tissue realignment may be combined with an osteotomy. This involves altering the tissue in your foot to help correct the deformity and improve the stability and appearance of the foot.
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