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Understanding Bunions

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SickNWell-Understanding-Bunions-1

Written by
SickNWell Staff Writer

 
 
 
Causes of Bunions | Causes | Epidemiology | Management |
What’s the Takeaway?

 

Overview

A bunion, medically known as hallux valgus, is a common foot deformity affecting millions worldwide. 

Bunions are characterized by a bony bump at the base of the big toe, which can cause discomfort, pain, and difficulty walking. 

This article will delve into the causes, epidemiology, etiology, and management of bunions, providing valuable insights into this prevalent foot condition.

 

Causes of Bunions

Bunions can develop due to various factors, with the primary cause being an inherited foot structure. People with a family history of bunions are more susceptible to developing them.[1] 

Additionally, wearing ill-fitting footwear, especially shoes that are too narrow or have high heels, can exacerbate the condition, contributing to bunion formation.[2] Moreover, certain medical conditions, such as arthritis, can increase the risk of bunions.[3] 

Understanding the underlying causes is crucial in preventing and managing this condition effectively. The development of bunions involves complex biomechanical changes in the foot structure. 

A critical factor in the etiology of bunions is the misalignment of the metatarsophalangeal (MTP) joint, where the big toe starts to drift inward, and the first metatarsal bone moves outward.[7]

This deformity leads to the formation of the characteristic bony prominence on the side of the foot. 

Several studies have identified abnormal foot mechanics and faulty gait patterns as contributing factors in the development of bunions.[8]

Moreover, the weakening of ligaments and tendons around the MTP joint due to aging or injuries can also play a role in bunion formation.[9] 

Understanding the etiology helps in devising appropriate treatment strategies.


Epidemiology 

Bunions are a widespread foot ailment affecting individuals of all ages, but they are more commonly observed in adults.

According to recent epidemiological studies, approximately 23 percent of adults in the United States suffer from bunions.[4] 

Women are more prone to developing bunions than men, with prevalence rates nearly three times higher in females, likely due to the types of footwear typically worn by women.[5]

The prevalence of bunions also tends to increase with age, making it a significant concern for the aging population.[6] 

These statistics highlight the need for increased awareness and proper management of bunions to maintain foot health.

 

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Management 

Early intervention and proper management are essential to prevent the worsening of bunions and alleviate associated symptoms. Conservative approaches should be the first line of treatment. These may include:

  1. Wearing Proper Footwear: Choosing comfortable shoes with a wide-toe box and low heels can help reduce pressure on the bunion[10]
  2. Orthotic Devices: Custom-made shoe inserts or orthotic devices can correct foot mechanics and provide support, alleviating pain[11]
  3. Padding and Taping: The use of padding or taping can help cushion the bunion and realign the toe, reducing discomfort[12]
  4. Physical Therapy: Specific exercises can improve foot strength and flexibility, promoting better foot mechanics[13]
  5. Medications: Over-the-counter pain relievers or anti-inflammatory drugs can help manage pain and swelling[14]

In cases where conservative measures fail to provide relief, surgical intervention may be considered.[15]

Surgical procedures aim to correct the alignment of the MTP joint and remove the bony prominence, restoring normal foot function and reducing pain.

 

What’s the Takeaway?

Bunions are a prevalent foot condition that can significantly impact an individual’s quality of life. 

Understanding the causes, epidemiology, etiology, and management of bunions is essential for both prevention and treatment. 

By adopting appropriate footwear, practicing good foot care, and seeking early intervention, individuals can effectively manage bunions and maintain optimal foot health. 

Furthermore, ongoing research and advancements in medical science continue to provide new insights into the condition, offering hope for improved management strategies in the future.

 

References:

  1. Aebischer, A. S., & Duff, S. (2020). Bunions: A review of management. Australian journal of general practice, 49(11), 720–723. https://doi.org/10.31128/AJGP-07-20-5541
  2. Yu, G., Fan, Y., Fan, Y., Li, R., Liu, Y., Antonijevic, D., Milovanovic, P., Zhang, B., Li, Z., Djuric, M., & Fan, Y. (2020). The Role of Footwear in the Pathogenesis of Hallux Valgus: A Proof-of-Concept Finite Element Analysis in Recent Humans and Homo naledi. Frontiers in bioengineering and biotechnology, 8, 648. https://doi.org/10.3389/fbioe.2020.00648
  3. Popelka, S., Vavrík, P., Pech, J., & Veigl, D. (2003). Deformity prednozí u pacientů s revmatoidní artritidou–výsledky operacní lécby [Deformities of the forefoot in patients with rheumatoid arthritis–results of surgical treatment]. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca, 70(6), 336–342.
  4. Nix, S., Smith, M., & Vicenzino, B. (2010). Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. Journal of foot and ankle research, 3, 21. https://doi.org/10.1186/1757-1146-3-21
  5. Ferrari J. (2009). Bunions. BMJ clinical evidence, 2009, 1112.
  6. S/O K S, R. Z. E., Lee, M., Chen, J., & Meng, N. Y. E. (2022). Do Patients Aged 70 Years and Older Benefit From Hallux Valgus Surgery?. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 61(2), 310–313. https://doi.org/10.1053/j.jfas.2021.08.009
  7. Kuhn, J., & Alvi, F. (2022). Hallux Valgus. In StatPearls. StatPearls Publishing.
  8. Nix, S. E., Vicenzino, B. T., Collins, N. J., & Smith, M. D. (2013). Gait parameters associated with hallux valgus: a systematic review. Journal of foot and ankle research, 6(1), 9. https://doi.org/10.1186/1757-1146-6-9
  9. Menz, H. B., & Lord, S. R. (2005). Gait instability in older people with hallux valgus. Foot & ankle international, 26(6), 483–489. https://doi.org/10.1177/107110070502600610
  10. Silfverskiöld J. P. (1991). Common foot problems. Relieving the pain of bunions, keratoses, corns, and calluses. Postgraduate medicine, 89(5), 183–188. https://doi.org/10.1080/00325481.1991.11700901
  11. Valdes, K., Boyd, J. D., Povlak, S. B., & Szelwach, M. A. (2019). Efficacy of orthotic devices for increased active proximal interphalangeal extension joint range of motion: A systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists, 32(2), 184–193. https://doi.org/10.1016/j.jht.2018.05.003
  12. Wülker, N., & Mittag, F. (2012). The treatment of hallux valgus. Deutsches Arzteblatt international, 109(49), 857–868. https://doi.org/10.3238/arztebl.2012.0857
  13. Hurn, S. E., Matthews, B. G., Munteanu, S. E., & Menz, H. B. (2022). Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta-Analysis. Arthritis care & research, 74(10), 1676–1688. https://doi.org/10.1002/acr.24603
  14. Oliver M. N. (2001). What is the best treatment for patients with symptomatic mild-to-moderate hallux valgus (bunions)?. The Journal of family practice, 50(8), 718.
  15. Scranton, P. E., Jr, & McDermott, J. E. (1995). Prognostic factors in bunion surgery. Foot & ankle international, 16(11), 698–704. https://doi.org/10.1177/107110079501601105