Nail & Skin Disorders

Under the Microscope: Bunions

A bunion is a bump on the side of the foot caused by an enlargement of the first joint of the big toe.

What is it? Bunions are caused when the arch of the foot drops. This forces the joint of the foot to carry a heavy load over long periods of time in ways it was not designed to. The toes begin to bend outward to compensate for the dropped arch, adding pressure to the joint. The pressure causes extra bony growth and fibrotic tissue to build up around the joint and a bunion develops. Left untreated, bunions can become quite painful and the joint can bend so severely that the big toe crowds out the other toes.

How do you get it? Often thought to be caused by poor footwear, bunions are most often the result of inherited foot structure. While heredity is the main culprit of misaligned bones and of the dropped arch that causes bunions, it’s not the only one. A foot injury can cause a misalignment, as can a neuromuscular disease or arthritis.  An occupation that puts extra stress on your feet can be a cause, as can high-heeled or ill-fitting shoes.

How is it treated? To alleviate the pain associated with bunions, clients can soak their feet in a warm bath, take a pain reliever such as Tylenol or Advil, or apply ice to the inflamed area. Other remedies providing immediate relief are wider shoes and bunion pads. Once pain develops from a bunion, it’s likely the condition will continue to deteriorate. There are many types of bunion surgeries, though often surgery will include a full or partial bunionectomy. A bunionectomy includes removing the swollen tissue around the big toe joint, straightening the toe by removing part of the bone, and permanently joining the bones of the affected joints.

What can a tech do? When a client comes in with a bunion, techs can inform her of the root problem of bunions: a flattened arch and a misaligned, highly-pressured joint. Techs can recommend a number of non-invasive treatments. It should be noted that non-invasive treatments don’t cure bunions. However, they can provide relief from the pain, and they may prevent the bunion from becoming more severe. A pedicure with a warm water soak may provide temporary relief.

What else? People with flat feet are more likely to develop bunions because of the lack of arch support in their feet. This doesn’t mean that bunions are guaranteed to develop if a person has flat feet, but it does mean those with flat feet need to be more proactive about foot care and bunion prevention. Custom orthotics are often a wise investment. Orthotics will support the arch and reestablish more normal movements. Additionally, clients with flat feet should avoid high-heels and narrow shoes. Poor footwear will add extra pressure to an already over-used joint.

David Martin, D.C. contributed to this article.

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