Bunions may present symptoms or it may go asymptomatic, or symptom-free at all. It presents big problems to the foot, especially when wearing shoes or walking around. Some symptoms are listed below.
Foot Pain
This is the most frequent symptom of a bunion, or a Hallux Vagus. It involves the affected area, especially when walking around or wearing unfitting shoes. It is relieved by rest. Persistent or intermittent pain may be felt.
Changes in the Big Toe
There is an enlargement in the base of the big toe. A bulging bump may also be felt in the outer area. There is also swelling, redness and a sore feeling around the big toe joint. Thickening of the skin at the base of the big toe may also be evident. The marked prominence of the medial aspect of the first metatarsophalangeal joint is the most apparent of all changes.
Corn and Callus Formation
Both corns and calluses form when the first and second toes overlap.
A corn is an area of hyperkeratosis (an overgrowth of a horny layer of epidermis) which is produced by an internal pressure due to the underlying bone that is prominent because of a congenital or acquired abnormality, commonly arthritis or an external pressure, such as ill-fitting shoes.
Calluses, on the other hand is a discretely thickened area of the skin that has been exposed to constant pressure or friction. It may be produced from flawed foot mechanics.
In acute bursitis, symptoms of reddish site, edema or swelling and tenderness of the affected site may be manifested.
Bunions (Hallux Vagus)
Hallux Vagus or Bunions is a deformity that is defined as an unnatural, bony hump that is formed at the base of the big toe where it joins to the foot. The big toe in most cases deviate towards the other toes, where it also pushes to the first metatarsal bone- the bone directly behind the big toe. Thus, a bunion in this case, is formed. Since these produce intense pain, they are easily vulnerable to excess friction and pressure and friction from shoes and could lead to the formation of calluses.
There are two classifications of Bunions. The first one is an acute bunion, which causes a very sharp, intense pain. It proceeds after a bursitis, which is a sudden outcropping of a fluid-filled sac. It could eventually progress into the second type, Hallux Vagus, where it is described a chronic yet pain-free deformity that includes a permanent stiffening of the bones.
Causes of Bunions
There are different factors that cause bunion formation, from preferences to personal factors.
Gender
Women are more predisposed to bunion than men, due to the different shoes that they wear that causes foot deformities.
Footwear Choices
After years of wearing tight, poorly fitted shoes such as high heels and shoes with pointed tips might also be a predisposing factor for bursitis. These kinds of shoes might give the foot an unusual shape. Ballet shoes by ballet dancers could also lead to bunions.
Genetic Factors
When a family member of a bloodline has experienced bunions, a person might be at risk to get one if he or she continues to wear ill-fitting foot gear. Congenital abnormalities of the foot bones may also be a predisposing factor.
Diagnosis
Although bunions do not really require medical intervention, appropriate interventions must still be done to properly diagnose a bunion.
The foot specialist (podiatrist) might ask these questions as part of the assessment:
- If there is a persistent foot pain or pain in the big toe
- A bump on the joint of the big toe that can easily be seen
- If there is lessened movement in the big toe and foot
- If there are no shoes that fits the feet well
The foot anatomy is also examined for any obvious changes. Diagnostic aids such as X-ray or Radiographs of the foot are done to test the integrity of the joints in the affected area, and it confirms any deviations of bones from the normal, such as the great toe and the metatarsal bone. It is also effective for screening other disorders, such as Arthritis and Gout. X-ray films are also an excellent way of calculating proper toe alignment. These X-rays are taken in a standing (weight-bearing) and non-standing (lying) positions. The angles are measured in connection with the examination and the clinical impressions so surgery could be scheduled. Other examinations to be considered include an MRI and CT scan. Each of these tests has its own advantages and disadvantages in a case-to-case basis. Physical examinations may be included to check looseness of ligaments and tendons around the affected site.
Blood and other pre-operative tests may be done if a person is scheduled for surgery. These are useful in detecting infection in site and for any deviations from normal CBC values.
