A bunion (from the Latin "bunio," meaning enlargement) is a protuberance of bone or tissue around the joint. The enlargement occurs either at the base of the great toe or on the outside of the foot, at the base of the little toe where it is called a "bunionette" or "tailor's bunion."

Bunions at the base of the great toe usually begin when the big toe starts moving toward the smaller toes when tight, pointed shoes are worn. This crowding puts pressure on the joint, pushing it outward. The movement of the joint in this outward direction starts the formation of a bunion.

A common deformity of the big toe joint, a bunion occurs mostly among people who wear shoes. Women are more frequently affected with bunions because of tight, pointed, confining or high-heeled shoes. Wearing high heels is especially stressful on the joints of the foot because all of the body's weight rests there. The foot is then forced into a narrow, pointed "toe box", compounding the problem. Older people are also vulnerable to bunions because of the higher incidence of arthritis affecting the big toe joint.

What Causes a Bunion?
A bunion is most often a symptom of faulty mechanics of the foot. The deformity runs in families, but it is the foot type that is hereditary, not the bunion. People with flat feet or low arches are more prone to develop the problem than those with higher arches. Bunions also may be associated with various forms of arthritis. Arthritis can cause the joint's protective covering of cartilage to deteriorate, leaving the joint damaged and with a decreased range of motion.

Parents who have bunions should know that there is a strong hereditary predisposition to bunion development, and should have children evaluated if early signs of deformity and/or discomfort are evident. If the child has the same foot type, there is a possibility that a bunion will eventually develop.

Symptoms
Pain from a bunion can be mild, moderate or severe, making it difficult to walk in normal shoes, especially high-heeled shoes. The skin and deeper tissues around the bunion also may be swollen or inflamed.

The other toes can be affected by a bunion, as a result of pressure from the great toe pushing inward toward the lesser toes. Toenails may begin to grow into the sides of the nail bed; the smaller toes can develop corns and become bent (hammertoes); or calluses may form on the bottom of the foot.

Treatments
Treatments vary depending on the severity of pain and deformity. Left untreated, bunions tend to get larger and usually more painful. Evaluation by a podiatric surgeon should be sought at the first sign of pain or discomfort, so that severe deformity can be avoided.

Moderate Bunion before and after treatment.

very cheap hotels Plitvicka JezeraSevere Bunion before and after treatment.

Early Treatment
The main goal of early treatment is to relieve pressure on the bunion and smaller toes, and to diminish the progression of joint deformities.

Padding the bunion is an important first step, as is wearing shoes that are large enough to comfortably accommodate the bunion (such as sandals, athletic shoes or shoes made from soft leather). Stiff leather shoes may be stretched slightly for greater comfort. Tight, confining or high-heeled shoes should be avoided.

Medications, such as nonsteroidal anti-inflammatory drugs or cortisone injections, may be prescribed to ease pain and inflammation caused by joint deformities.

Physical therapy, ultrasound treatment, whirlpool baths or other techniques can also provide temporary relief.

Orthoses (shoe inserts) may be useful in controlling abnormal foot movement, and may reduce symptoms for those with a painful bunion that has not yet caused a significant bony abnormality at the joint. If a systemic disease like rheumatoid arthritis or gouty arthritis is related to the bunion, appropriate medical treatment may be recommended.

Surgical Treatment
When conservative treatment does not provide satisfactory relief from symptoms, or when the condition interferes with your activities, surgery may be necessary.

Pain and deformity are significantly reduced in the great majority of patients who undergo bunion surgery. In addition to easing pain, the purpose of bunion surgery is to remove the enlargement and realign the joint to restore normal function. This means that after surgery, the foot can carry the body's weight properly, and that special shoes are no longer needed. Postoperative orthoses or supportive devices may be recommended to improve foot function.

Surgery may be performed at a hospital, surgical center or properly equipped office operating room. Depending on the procedure, the facility at which it is performed and the patient's medical status, the surgeon may choose a local, spinal or general anesthetic. In many cases, the procedure can be performed under local anesthesia.