A PROBLEM IN YOUR BIG TOE

Your big toe is the hardest-working toe. Every time your foot pushes off the ground, this toe supports most of your body's weight. Because the big toe is so critical to movement, any problem with it can make walking or even standing painful. A bunion (excess or misaligned bone in the joint) is one of the most common big-toe problems. In addition to causing pain, a bunion changes the shape of your foot making it harder to find shoes that fit.

WHAT CAUSES BUNIONS

Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics which forces the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis or an injury produces a bunion, and wearing high-heeled or poorly fitting shoes makes the problem worse.

TYPES OF BUNIONS

Position bunions arise from the growth of new bone. Structural bunions result when the joint at the base of the toe shifts position. Many bunions are a combination of both types.

POSITIONAL BUNIONS

As new bone grows the joint enlarges. This stretches the joint's outer covering. Force created by the stretching pushes the big toe toward the smaller ones. Eventually the inside tendons tighten wich polls the big toe farther out of alignment.

STRUCTURAL BUNIONS

When the angle between the bones of the first and second toes is greater then normal, the big toe slants toward the smaller ones. In severe causes, this may also cause the second and third toes to buckle.

TESTING

X-rays may be taken of your foot to show the position of the big -toe joint. Your doctor may also want to see whether the bunion is affecting other bones in your foot.

To see how well a joint works and to learn if movement causes pain, your doctor may move the joint back and forth.

PHYSICAL EXAM

To determine the best treatment for your problem, your doctor may also test how far and how smooth the affected joint moves. To see if incorrect foot mechanics is causing your problem, your doctor may watch how your feet rotate and flatten as you walk.

HOW ARE BUNIONS TREATED?

If a bunion is not severe, your doctor may recommend that you wear a different style of shoes. Or you may be prescribed custom-made shoe inserts (orthotics) to control incorrect foot mechanics.