While bunions cannot be reversed, they can be treated to reduce pain and improve mobility. By knowing what a bunion looks like and how it is likely to progress, you can know when it is time to see a healthcare provider and seek appropriate care.
While we tend to associate bunions with older people, they can often start to develop as early as childhood.
While symptomatic hallux valgus is most commonly seen in people over 65, as many as 23 percent of cases will involve younger adults, according to research from the University of Queensland in Australia.
Generally speaking, the angle should be no greater than 15 degrees. The greater the angle, the greater the need for intervention. To determine the appropriate course of treatment, an X-ray would be used to grade the severity of the deformity on a scale of 1 to 5:
Grade 1: 0 to 14 degreesGrade 2: 15 to 29 degreesGrade 3: 30 to 44 degreesGrade 4: 45 to 50 degreesGrade 5: 60 degrees or more
The problem with a high-grade defect is more than just cosmetic. It is an indication that the ligaments around the joint space have been hyperextended and are now lax. What this means is that the very architecture of the foot—particularly the toes that help keep you balanced—is inadequately supported and vulnerable to instability.
Although a hammertoe can be straightened to a certain degree, it will return to a bent shape when relaxed. One of the telltale signs of a hammertoe is the formation of a callus at the top of the middle joint.
Calluses will also typically develop along the edge of the bunion and the outer edge of the big toe. These are areas where the foot is being constantly abraded by the inside of an ill-fitting shoe. While this occurs more commonly in women, it can also affect men who wear improperly sized work shoes or those with a narrow toe box (such as cowboy boots).
When the first metatarsal bone is normally aligned, the sesamoid will be directly beneath it. When the metatarsal bone begins to drift, the sesamoid will be displaced and seen on an X-ray as an independent circular bone floating between the first and second metatarsal bones (more or less where it was originally positioned).
This can lead to a condition called sesamoiditis, characterized by inflammation of the sesamoid bone and surrounding tissues. It is a form of tendinitis commonly seen in dancers which trigger pain, redness, and swelling at the base of the big toe.
Tailor’s bunions may cause pain but are typically less impactful than those situated near the first MTP joint. Oftentimes, the toe position can be temporarily corrected with the use of a toe spacer found at most drugstores.
Tailor’s bunions were so-named because tailors of the past typically sat cross-legged, a condition that some attributed to the development of the abnormal bump.
Hallux limitus is the term podiatrists use to describe the loss of motion in your big toe joint. It is associated with osteoarthritis and characterized by morning stiffness and chronic joint pain.
Hallux rigidus is the end stage of hallux limitus by which the ossification around the MTP joint has essentially cemented the bones in place. Without the means to flex your toe, your gait will be lumbered. Not only will you walk flat-footed, but your knees would be slightly bent to compensate for the loss of the shock absorption from your feet.
By this stage, the only reasonable form of treatment is surgery to not only realign the bones but restore the range of motion to the affected joints.
As such, if you look at your feet and notice anything you think could be a bunion, seek the advice of your healthcare provider sooner than later for the best outcome.
