Bunions: Symptoms, Treatment, Diagnosis

Bunions are a condition that is more common in children and women and is orthopedic in nature. It is characterized by the curvature of the foot's axis, when the middle part of the foot drops and thickens. In addition, problems such as big toe deformity, characteristic bulge, and muscle and ligament balance may also occur.Other names for the condition: hallux valgus, hallux valgus.Main symptoms: pain when walking, fatigue, and foot axis bending.Treatment is performed by an orthopedic traumatologist.

An article for doctors diagnosing patients with a disease. It is not intended to replace a doctor's appointment or be used for self-diagnosis.

reason

The development of a valgus deformity of the foot is almost always of a complex nature. In most cases, a combination of the following prerequisites is required:

• Flat feet can be divided into congenital and acquired conditions. Due to its presence, weight and pressure are distributed unevenly, resulting in deformation of the toe.
• Osteoporosis, characterized by loss of bone stiffness and low calcium levels.
• Obesity and being overweight can put excessive stress on bones, especially muscle weakness.
• When ligaments are weak, the genetic predisposition, as well as the characteristic changes in the foot (bunions), can be genetically predetermined.
• Wearing the wrong shoes. The problem often occurs in women due to walking in uncomfortable narrow heels. In this case, the correct loading of the foot is disrupted and the likelihood of hallux valgus deformity increases.
• Injuries, such as something heavy falling on the leg, a broken bone, or a bruise, can cause the foot to become deformed.
• Associated diseases of the endocrine system and nervous system.
• Hormones fluctuate dramatically, including during menopause, pregnancy, and during the natural course of the menstrual cycle.

Bunions can be caused by any one or a combination of these causes. However, it is not always possible to objectively determine the exact basis for the development of bunion valgus. In this case, the most important thing is the treatment process.

stages and forms

One of the main criteria for assessing the severity of foot deformity in children and adults is the angle of deviation of the big toe. The larger it is, the more serious the pathology is. According to her:

• First stage -15°;
• II - 20°;
• III - 30°;
• IV - over 30°.

It is necessary to comprehensively evaluate not only the degree of hallux valgus deformation of the first toe, but also the degree of hallux valgus deformation of the rear toes. One classification is based on the mounting of the heel relative to the tibial axis:

• Stage 1 - flat feet present but with slight deviation up to 15°;
• II - up to 23°;
• III - up to 30°;
• IV - the foot becomes completely flat with a deviation of more than 30°, which is considered a severe form.

Generally, according to the severity and curvature of the disease, the following types of disease processes are distinguished:

• lung;
• average;
• Heavy.

Depending on how they form, foot deformities are divided into the following types:

• Structural, caused by congenital pathology;
• Static, caused by spinal curvature;
• Cramps due to overexertion or muscle tension;
• Traumatic foot deformity;
• Rickets etc.

As a result, there are many types of deformities in the first toe and other parts of the foot. To determine the characteristics of the course of the disease, it is necessary to consult a doctor and conduct examinations.

symptom

The special insidiousness of its pathology lies in the fact that it does not manifest itself for a long time. Often, a person simply doesn't notice warning signs, including calluses forming in the same places and feeling tired soon after walking. Significant problems only appear after the disease reaches more severe stages, which complicates and prolongs treatment. Symptoms of bunions can vary and include the following:

• fatigue when walking;
• corn;
• Calluses often appear in the same places;
• pain;
• Increased swelling of the lower limbs;
• Thumb to one side;
• Formation of characteristic bumps, often called "phalanges";
• The remaining toes deform and become hammertoes.

As the foot deformity progresses, the patient notices that the shoes he previously wore no longer fit him properly. It becomes narrow and uncomfortable due to tissue thickening, the appearance of new calluses, and an increase in bursitis.Finding shoes becomes difficult and sometimes almost impossible. In the advanced stages of bunions, pain worsens and increases, discomfort occurs in the knee and hip joints, and the load on the spine increases. In the first stages of bunions and other areas of the foot, patients are often only concerned with cosmetic issues.

complication

One of the terrible consequences of lack of treatment is not only the progression of the pathology, but also the increase in other related problems. As bunions progress, negative consequences may occur. The most common are the following:

• Bursitis, inflammation of the bursa. The problem manifests itself as swelling and pain in certain areas of the foot due to deformity of the foot joints.
• Arthropathy is the destruction of cartilage, resulting in reduced joint mobility, pain, and gait disturbance.
• The increased load causes wear and tear on the knee joint, increases pressure on the spine, and develops joint disease.
• The formation of heel spurs. In this condition, severe, almost unbearable pain occurs when walking.
• Achilles tendon bursitis and other diseases.

In addition, bunions always present serious aesthetic problems, which are especially noticeable when wearing open-toed shoes. This can cause a person great psychological discomfort, which can have a negative impact on their overall mental and emotional state.To avoid adverse consequences, prompt treatment is required. The medical center employs experienced physicians to help patients with any form and degree of ectropion.

diagnosis

At the initial appointment, the orthopedic traumatologist will conduct a thorough examination and examination of the patient. To do this, he visually assesses the condition, position, deviation of the foot and determines whether there is any deformation of the forefoot. However, this is not sufficient to draw final conclusions about the extent and nature of the problem, so further research is needed.

Instrumental methods

One of the primary methods of evaluating hallux valgus is three-projection radiography. It can identify not only this problem, but many others, including subluxations, dislocations, and arthrosis. Based on the results of this examination, the size of the angular deviation can be estimated, calculations can be made and a treatment plan for bunion valgus can be correctly formulated.For a more detailed study of hallux valgus deformity, or if necessary, additional studies:

• If a problem with local circulation is suspected, ultrasound can identify disturbances in blood vessel function.
• Computed tomography or magnetic resonance imaging will help rule out other pathologies similar to bunions and obtain more detailed images of the disease.
• Plantar photography allows you to identify and determine the degree of flat feet.
• A plantar examination is an examination of the soles of the feet in a standing position.

There are currently no specific laboratory studies for diagnosing bunions in adults and children. Usually the tests listed are sufficient, but your doctor may prescribe additional tests if necessary. Bunions may resemble other conditions, so differential diagnosis is particularly important. The most common of these are:

• gout;
• Osteoarthritis;
• arthritis.

Modern medical clinics have the latest diagnostic equipment. This allows you to quickly identify a bunion and allow for a thorough examination and treatment.

Treatment of bunions

Today, experts have a variety of ways to help people with foot deformities. Even the first phase of treatment may vary depending on the characteristics of the specific case. Bunions in adults sometimes begin immediately after surgical intervention if the extent of the disease is already severe.

conservative approach

There are many methods and techniques that can help avoid surgical treatment, especially in the initial stages of pathological development. The most common ones are the following:

• Wear orthopedic shoes. It should be securely fastened, with a stable and low heel and extended toes. Additionally, special insoles, support pads, and other devices can be used to remove excess load from the metatarsal bones. It is important to understand that this treatment for bunions is usually long-term, lasting more than six months and sometimes even a year.
• Physical therapy sessions. Exercise therapy coaches select a program for a specific patient and teach the proper technique for performing the exercises. It is important to consult an expert during the first stages.
• Foot massage. It can only be performed in specialized medical centers, since its purpose is not relaxation, but the treatment of ectropion.
• Taking NSAIDs can both reduce the inflammatory process and relieve pain. It is important to consult a doctor before using such medications.
• Proper nutrition, a diet rich in calcium.

Additionally, it is useful to treat bunions using physical therapy procedures, which may include:

• sonophoria therapy;
• UHF;
• Magnet therapy.

During the treatment of bunions, it is recommended to avoid standing for long periods of time and focus on strengthening the muscles and ligaments.All of these methods of treating bunions can be used in combination or individually. The course is developed by the physician based on the circumstances and complexity of the specific case. But they are more suitable for treating patients with early stage hallux valgus or early hallux valgus.

surgical method

If conservative treatments for the foot deformity don't work, or if the problem is discovered at an advanced stage, surgery may be necessary. It has its advantages because the problem can be solved in one stage, whereas non-surgical treatment of various parts of the foot deformity usually takes years.Today, doctors perform appropriate procedures, of which there is a wide variety. It depends on what type of surgery is relevant for a particular patient. According to this standard, surgery to correct bunions is divided into the following types:

• on soft tissue. In this case, at an early stage of pathological development, it is possible to treat bunions in children and adults using the Silver and McBride techniques. They are associated only with the first stages of the disease.
• A combination of actions on bone and soft tissue structures to treat foot deformities, such as the Schede procedure.
• On the bone. This type of intervention is called an osteotomy, and there are several types. It is most commonly used in adults with moderate to severe foot deformities.

In many cases, modern surgical treatment methods for patients with foot deformities allow for percutaneous or laser intervention, for example, resurfacing of the "bones" of hallux valgus. If minimally invasive treatment of hallux valgus deformity can be performed, the advantages are obvious:

• Fast recovery time;
• No large cuts or seams;
• No long-term hospitalization required;
• The risk of complications is low.

The goal of any type of intervention is to bring the foot closer to its natural and normal state. However, doctors will consider the individual structure of a patient's leg because it is unique.Recovery after corrective bunion surgery requires varying amounts of time: from 2 weeks to 4 months, depending on the extent of the intervention and its complexity. During recovery, you will need to wear special shoes, follow your doctor's recommendations and use medications.

Children’s Treatment Features

Parents are often the first to notice bunions in their children. If it occurs early, it will become apparent when the child starts walking around one year old. Sometimes, a pediatrician will notice a deviation and can reveal it and refer you to an orthopedic surgeon.This situation can be corrected with conservative treatment if prompt medical attention is given. If your baby's arch is in a valgus position, in most cases the problem can be resolved without surgery.If at an early age, a valgus bend occurs when the foot is placed, massage, physical therapy, physical therapy and other methods are used. However, one of the main ways to correct this condition is to wear orthopedic shoes. It is selected individually; it must be replaced as the child grows and the angle of the foot changes.Surgical treatment is rarely used, and the issue of surgical selection is always dealt with individually. For minor injuries, they try not to use radical treatment.The prognosis for treatment of first toe deformity and valgus in children is usually positive. If you follow all your doctor's recommendations and systematic observation, it is possible to completely restore the normal appearance and function of your foot.

Which doctor is treating you?

Treatment of bunions has traditionally been performed by orthopedic traumatologists. This specialist will help the patient if the first symptoms of the disease are detected or for preventive purposes. In the case of children, specialists must have the skills and experience to treat such patients. If radical treatment of bunion is required, a surgeon's involvement is required.

forecast

With correct and timely treatment, bunion deformity can be successfully eliminated. In most cases, the pain can be stopped and ideal cosmetic results achieved. Treatment is particularly effective in young children and in the early stages of the development of the problem.However, it is doable if you follow all expert advice along with early diagnosis. In severe cases, treatment of bunions is possible but takes longer and requires the use of more severe interventions. In particularly severe cases, there is a risk that the foot will not be fully restored to its original condition.

prevention

There is no reliable way to absolutely prevent bunions. It is multifactorial in nature and is often due to a genetic predisposition. However, there are ways to reduce the risk of its occurrence or eliminate it in the early stages of development:

• Regular preventive examinations by an orthopedic traumatologist;
• Find and treat flat feet promptly;
• Wear comfortable shoes, excluding women's stilettos;
• Use orthopedic insoles if necessary;
• Control your weight and keep it in a normal and optimal state;
• Adhere to rest and work standards, especially if a person's occupational activities are associated with increased pressure on the legs;
• Eat proper and balanced nutrition and get rid of bad habits;
• Moderate physical activity, which means no physical inactivity and undue stress on the legs.

At Modern Medical Center, you can receive modern diagnosis and treatment at any stage of bunion development.