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| What
You Need To Know About... Bunions |
It's more Serious Than You Think
What Are Bunions?
Bunions are a common problem that most people experience
as a bony protuberance at the base of the big toe. The
problem, however, is more complicated than simply a
bump.
The most common cause of bunions is due to the big toe
angling in towards the other toes, a condition called
hallux valgus. The condition is most common in women,
and the cause is usually wearing unsuitable footwear,
particularly during adolescent growth.
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| High Heels And Pointed
Toes Shoes Can Hurt Your Feet |
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Shoes such as high heels are particularly damaging.
These shoes have a sloping foot piece and a narrow
toe box. The slope causes the front of the foot to
be pushed with force into the narrow toe box. The
narrow toe box causes the toes to become squeezed
together.
Depending on factors such as duration of wearing constraining
footwear, skeletal maturity, and individual factors,
the toes can become permanently adapted to the new
position. Patients can also be genetically predisposed
to this problem, a condition called metatarsus primus
varus. This simply means that the individual is born
with a great toe that is already angulated.
As the big toe becomes more and more angulated (pointing
towards the other toes), the base of the toe becomes
more and more prominent, thus forming the bunion.
The bunion forms in part because of the new angulation
of the toe, and in part due to inflammatory changes
over the surface.
As the inflammation worsens, people can experience
pain with walking, and even be more susceptible to
infections. The big toe may eventually come to lie
over, or more commonly under, the second toe. This
may cause further irritation while wearing shoes,
and cause more pain.
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| How To Treat Bunions |
Treatment of bunions is usually
conservative at first, and usually means wearing more
appropriate footwear. This does not necessarily imply
wearing bulky orthopedic shoes, but it does require
that you find comfortable shoes with a wide toe box.
Surgical treatment is
often the next step. Rarely, the bunion can simply be
shaved off, but usually the surgical treatment is more
extensive-otherwise the problem will simply return.
The surgery involves breaking the toe bone to correct
the alignment. There is also a tightening of the ligaments
on the outside of the toe, and a release of the ligaments
on the inside so the tension on the ligaments points
the toe in the proper direction.
The drawback to surgery is that you will have pain in
the foot, and probably not be completely healed for
about three months. That said, if bunions are causing
you problems in walking, it is certainly reasonable
to consider this type of treatment.
This article is courtesy of Jonathan Cluett, M.D. originally
published on 11/2000
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