Understanding Bunions

Bunions are one of the most common foot problems. It is a deformity at the base joint of the big toe. Technically referred to as Hallux Valgus, it may not cause any pain or discomfort and many people go through life without their bunions being a cause for concern. But bunions can also lead to inflammation and pain, often to the extent of affecting mobility. Dealing with bunions is easier if you understand what they are.

What exactly is a bunion?

The condition exists when the big toe is angled or tilted towards the adjacent second toe. This causes a bump to form on the side of the foot at the base of the big toe, next the joint that connects it to the foot. Usually, the skin and tissue next to the joint become hard and thick. Such hard thickened tissues and skin become inflamed, painful and swollen. A fluid filled sac may also develop over the joint.

Why do bunions develop?

Bunions develop when the pressure on the foot, caused by the shifting of body weight, falls unevenly on the joint and tendons of the feet. This results in a partial imbalance that makes the big toe unstable to the extent where it bends inwards towards the second toe. When this happens, the joint at the base of the big toe is molded into a hard knob that sticks out from the side of the foot. Experts differ on why this happens but some of the most accepted causes are:

• Wearing shoes that are too tight, of the wrong shape or with excessively high heels. The American Academy of Orthopedic Surgeons says that 90% of people with bunions are women. Another statistic is that over half the women in the U.S. suffer from bunions. This shows that narrow, pointed high heeled shoes are a major contributor to the development of bunions.
• Foot injuries
• Congenital deformities right from the time of birth
• Inherited foot types that run in the family
• Having flat feet
• Inflammatory joint diseases such as arthritis

Because the bunion projects out from the side of the foot, it tends to run against the inner side of a shoe, leading to the skin becoming thick and inflamed.

What happens if you have bunions?

Bunions can develop on one or both feet. Once a bunion forms, there is no way to shrink or remove it except for surgery. Most people with bunions accept them as an inevitable part of modern lifestyles where spending a long time on one’s feet and wearing shoes that may not be the most comfortable are part of the price that has to be paid. Because bunions typically develop very slowly, they are often unnoticed until the projection at the side of the foot is too prominent to be missed or the pain begins. If left untreated bunions can become increasingly painful and in severe cases, cause mobility problems that can impact daily activities.

Symptoms and Problems

Among the many signs of bunions, besides the visible projection from the side of the foot, are:

• Pain when walking to the extent of making movement difficult
• Inflammation of the big toe which can often become swollen and infected
• An increase in the width of the foot requiring broader shoes to be worn
• The development of arthritis in the big toe
• Pressure on the second toe causing it to become deformed
• In very severe cases, the big toe may push the second toe out of position.

How Your Feet Work

The human foot is one of the complicated parts of the body and understanding its structure and how it works can help in taking care of it. The foot has 26 bones and 33 joints, all of which are in use with every step we take.  These bones and joints are grouped into 3 sets –those in the front, middle and back of the foot.

The Front of the Foot: The front of the foot, also known as the Forefoot, comprises of phalanges or toe bones. These connect to the five long bones (metatarsals) in the mid foot by joints. The joints in the toes do not move very much. It is the forefoot that bears half of your weight when you walk.

The Middle of the Foot: Also known as the Midfoot, this is made up of the five tarsal bones which form the arch of the foot. These bones are connected to the front and back of the foot by muscles and the arch ligament which is known as the Plantar Fascia. Damage to the ligament leads to the common conditions of Plantar Fasciitis or pain in the heel or sole of the foot. The muscles and ligaments function as shock absorbers to reduce the impact of contact with the ground while walking or running.

The Back of the Foot: The back of the foot, which is often called the Hind foot, consists of the heel bone (calcaneus) and the ankle (talus). The two parts are joined by the subtalar joint which allows the foot to move from side to side.

The Movement of the Feet

The bones in the feet are connected to the muscles of the lower leg by tendons. It is these that provide the flexibility allowing us to walk, stand, jump or go up on the toes. The muscles control the movement and positioning of the feet so that they are remain flexible and are able to absorb the impact of walking. They also help to push your body forward when walking by making the arches of the foot stiffer. The heel bone is attached to the calf muscles in the lower leg by the Achilles tendon which is one of the most critical tendons for the movement of the feet. It bears a lot of strain which is why Achilles tendon injuries are very common. The Tibalis Posterior tendon connects the lower leg to the underside of the foot. This provides additional support for the arch of the foot. There are also a number of nerves in the foot. These are what carry the sensation felt by the toes and soles of the foot to the brain.

The feet are far from simple. And they carry our body weight under all kinds of conditions, often for hours on end. Because they are naturally tough it is easy to ignore them. But the same complexity that enables the feet to perform their functions can also be the reasons for foot problems. A minor muscle or tendon problem, if not given proper and timely treatment, can escalate into a more serious medical condition which, in severe cases, can affect mobility.

In general, proper hygiene and wearing the right type and size of shoes will offer protection from most medical conditions. But if a problem does arise or if an injury occurs, ignoring them can be a serious mistake. Consulting a podiatrist in time can often mean the difference between a quick and simple cure and a long and painful one.