Bunions are swelling on the big or the great toes of the feet. Shiel defines it as, "The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe" (Shiel, par 1). He further describes them saying, "The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe" (Shiel, par 1). Pray says that they are also known as Hallux valgus deformities, which results from hypertrophy, which is excessive growth or growth past normal measures of the bone and the ligaments around the middle of the great toe (Pray 651). A bunion is therefore "an enlargement of the common integuments over the first joint of the great toe, seldom affecting both feet at the same time, caused ether by compression, or by unnatural obliquity of the great toe outwards by which the position of the joint between it and the metatarsal bone is changed" (Durlacher 75). This swelling will cause inflammation at the joint area, reddening and is hurting. The Bursa, a fluid sac close to the joint can become inflamed, causing more swelling, redness and hurt. This condition is termed as bursitis. A number of situations results to bunions are as further discussed in this paper.
First, bunions are hereditary. Some families pass down these conditions from one generation to the other. A good percentage of the patients with bunions have shown positive family history of the disease, showing that genetics plays a role. "There is a positive family history in as many as 60% of patients with bunions, although inciting factor is required to produce bunions, in most cases..." (Pray 652). Langer also says, "...history tends to run through families" (Langer 87). Most of the people acknowledge that bunions are hereditary, but ascribe more to the aspect of them as being caused by the shoe-wearing factor. This is as Duke says, "Bunions are sometimes caused by hereditary weakness called hallux valgus" (Duke 100). He further says, "But more often, especially in women, they result from trying to force the foot into a pointy-toe high-heeled shoe" (Duke 100). Reflecting upon Langer and Pray's statements, we conclude that heredity is the pedestal cause, which is incited by wearing the narrow-toe high-heeled shoes. This does not rule out the fact other people who are not genetically related to people who have had this condition will not develop this problem. It is therefore clear that both cases play a role, but in runs through families. Many people simply focus on the inciting factor and forget to trace the root cause.
Bunions develop on feet that have vulnerable structures and combine with poor footwear. Langer acknowledges that no one is borne with bunions but some feet are highly susceptible than others. He states that " A big toe joint that is too flexible, an arch that collapses too easily, or a joint surface that has peculiar contour (something that can only be seen using an x-ray) are structural vulnerabilities that contribute to the formation of bunions (Langer 88).
This, together with the poor fitting shoes will result to bunions.
One of the most prevalent causes of bunions is wearing shoes that have narrow toe box, and high-heeled. This imposes a great pressure on the foot, both in a lateral and in a longitudinal direction. This throws the whole weight of the person on the metatarsal bones of the small and great toes. The space is so small in such shoes that the foot cannot expand itself due the weight it is receiving from the body. This also hinders the normal movement of the muscles of the joints on the toes. It then results to agonizing pain, swelling and improper positioning of the great toe. Finally, there is formation of the bunion.
Weather the root cause is hereditary or by the positional distortion of the big toe, the big toe that is supposed in a straight line with metatarsal bone that supports it lies across and above or below the next toe as shown in the diagram below.
This makes the joint to protrude, and on continuous subjection to the stress, the severity increases, the inflammation enlarges, and fully becomes a bunion.
There are also constitutional causes of bunions. As Durlacher explains, "Constitutional derangement, producing a relaxation of the system, may also act as an occasional cause of bunions in persons predisposed to that complaint, by including a feebleness in joints, principally of the great toe, with pain after walking, which continues after the shoes have been removed and the feet are at rest" (Durlacher 74). Unique circumstances of atmospheric pressure influences this cause.
Other constitutional causes are rheumatism and gout. They increasingly bring deformity to the feet. They "...distort the does, and carry, by the contraction of the flexor tendons, the point of the great toe, obliquely across the others, and thus produce that state of foot by which the enlargement of the joint, constituting a bunion is caused" (Durlacher 74).
Age also is another factor that accelerates the formation of bunions. At an advanced age, the fluids the body cannot be produced with the usual quantity. They are less that when a person is younger. This is especially the case of the joint lubricants. The joints in turn become stiff, and on the toes become anchylosed, "from the want of sufficient synovial" (Durlacher 74). This condition is frequent among the old people.
Another interesting thing is that some studies have related bunions with sugar balance problems in people. Among the Japanese people, bunions are referred to as "sugar toes" because the reason behind their formation is excessive sugar intake, and due to the spleen's failure to transport and convert sugar in foods resulting to a damp.
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The damp is the failure of the spleen to transport and convert sugar. Abbate states that, "The damp the leads to the formation of phlegm" (Abbate 25). Abbate continues to say that, "The phlegm congeals such that an actual bonny deformation appears" (Abbate 25).
Under the epidemiology of bunions, gender comes to high focus. Pray says that, "the bunion is 10 times more common in females than males, clearly the result of wearing tight shoes with high heels". (Pray 652). Pray further says, "These shoes exacerbate a genetic tendencies to bunions by placing pressure on the firs metatarsal" (Pray 652). Duke also observes that they are more often in women (Duke 100). From the above authors and from observation of the people who have had bunions, it is agreeable fact that women are the ones that suffer more from bunions than men do. In addition to gender, the age is also selective. Bunions occur more on older people of age between 40 and 60 years and above. However, a few cases of juvenile bunions occur. It is therefore clear that the explicit difference is on fashion of footwear and that is why women are the most hit cases.
If the condition is discovered at an early stage, the patient is advised to do away with the causing factors. This will call for changing the footwear, from the tight fitting high-heeled shoes to flat or almost flat shoes that allows the body weight to be spread equally all over the feet. This is what Langer advocates when he said, "If you have bunions your initial treatment will involve changing your footwear: wearing wider shoes using supportive insole or orthotics, or inserting toe spacer between the big toe and the second toe" (Langer 88). The times when changing the footwear do not respond, surgical solutions may be recommended. Langer continues to say that, "A number of surgical procedures are available depending on the size of bunions, the level of pain and the lifestyle of the patient" (Langer 88). Surgical processes are not the best because in most cases, they cause more harm. "Surgery is often, but not always, successful, and failure to relieve pain can result from the big toe moving back to its deviated position before the operation" (Shiel, par 13).
Some of the non-surgical treatments are shoes, where the women patients have had to give up wearing narrow toe box and high-heeled shoes to wear wider and more flat shoes. It is therefore good not look at fashion and embrace fashion at the expense of your feet. The shoes that one should ware should have a round toe box as opposed to the very narrow toe box. This will reduce the pressure on the bunions considerable, thereby reducing the swelling and the inflammation.
The other thing is the use o f toe spacers. This tries to restore normal toe alignment by pushing the great toe away from them the second toe. This relieves pressure on the joint. "Toe spacers are made from form, rubber, or silicone gel and are available in different sizes" (Langer 89). One cannot determine the exact size of the spacer for his or her foot. This will take trial and error to get it.
Bunion shields or puddings are also used to correct this disorder. Producers use moleskin, rubber or silicone gel to make them. They are worn together with shoe. Some hold on to the skin while others cover the big toe with a curved pad to protect the bunion. They help from preventing excessive pressure from the bunion.
Patients should use insole and orthotics to reduce pressure on the great toe by giving support to the toe and controlling some forces that resulted to bunions. They are combined with spacers to give the best effect.
As we have mentioned above, surgical corrections are also one of the methods of treating bunions, although it is not highly recommended. This treatment only applies to bunions that have not improved on giving the patient the basic therapies, to remove the condition. We have numerous surgical methods, and the professionals to recommend the right ones are the podiatrist and orthopedist (Clarke, Meridith and Katherine ). The only good thing about the surgical procedures is the relatively quick recovery, that the previously discussed methods. For very severe bunions, very intricate surgery is used. This will lead to the patient putting on a cast to use crutches for quite some time. Langer says, up to six weeks.
Surgical procedure "involves removing the bump of bone and releasing contracted tissues" (Langer 90). He further explains, "More involved procedures require cutting the metatarsal bone, straightening it, and fastening the bone fragments with screws or wires until they heal" (Langer 90). Specialist are forced to fuse the bone at the middle of the foot using artificial fasteners e.g. screws to control the posture of the toe. This with time may eliminate the bending of the toe. Though studies show that that 90% of the patients are satisfied with the surgical treatment, it is very evident that its side effects are many. "These potential complications include joint stiffness, infection, painful scarring, unresolved pain, recurrence of the bunion, the failure of the bone to heal, and chronic swelling of the foot" (Langer 91).
Professionals also apply reflexology in the treatment of bunions. Though reflexology originally intends to use the foot to heal other parts of the body, we now look how the various parts of the body are related to the regions of the foot attacked by bunions. As we have seen earlier on, the spleen's failure can cause the formation of bunions. The picture alongside shows the path through which the bunion region is linked with the spleen. Abbate recommends patients should fast deal with sugar problems rather that dealing with the bunion itself.
This is one of the outstanding type of reflexology treatment.
Abbate insists on this saying, "Invariably, every patient I have seen with bunion problems has had one of the following illnesses pertaining to sugar history: diabetes; hypoglycemia; sensitivity to sugar; sugar cravings; sugar allergies; pancreatic cancer; or leaky gut syndrome" (Abbate 25).
Other studies say that bunions are because of congestion in the spleen or pancreas, and begin at the toe, run up the leg, goes through the pelvis and abdominal area to the shoulder, as shown in the picture above. The therapy for healing them with that in mind is not available. Only in some times, massaging ton and around the bunion will help relieve pain and reduce the swelling on the joint.
This paper has defined the condition of bunions, explicitly showing the prevalence of the disease. The paper has shown that hereditary cases are common, and they are exacerbated by poor footwear. The discussion has also focused on the gender, and has pointed out that it is more prevalent among the women because of their shoe fashions. Changing the type of shoes from narrower toe box high-heeled shoes to round and spacious flat shoes is the initial treatment. Surgery may be involved if the bunions are stubborn. Reflexology is also another method of therapy. In this, patients who take a lot of sugar are advised to reduce the consumption.