PHYSICAL THERAPY FOR BUNIONS

What is a Bunion?

A bunion is a bump that forms on the side of one’s big toe or little toe. Bunions form when bones located at the front of the foot move out of place. When this happens, the base of the toe sticks out, thus causing the skin around the base to become red and irritated.

Foot Anatomy

The foot can be broken down into three parts: the forefoot, the midfoot, and the hindfoot. The forefoot consists of the five toes, also known as the phalanges, and the five long bones that lead to the toes, also known as the metatarsals. The midfoot is a collection of bones that resembles a pyramid shape stemming from the arches of the feet. This collection of bones includes three cuneiform bones, the cuboid bone, and the navicular bone. The hindfoot includes the heel and the ankle. The ankle is formed by leg bones, also known as the tibia and fibula, and is supported by the talus bone. The heel bone, also known as the calcaneus, is the largest bone in the foot and is located at the very back of the foot.

The big toe is made up of two joints. The metatarsophalangeal joint (MTP) is the largest, where the long bone of the foot meets the first bone of the toe. Bunions typically develop at this joint.

Foot anatomy also consists of muscles, tendons, and ligaments that stretch throughout the surface. These allow for motion and balance. More specifically, the achilles tendon functions by connecting the heel to the calf muscle and is necessary for running, jumping, and standing.

Bunions Signs & Symptoms

One of the main bunion symptoms is a bulging bump emerging from the outside of the base of the big toe or the pinky toe. This can cause swelling, redness, or pain around the joint. Another symptom is a corn or callus, often developing between the first and second toes due to rubbing against one another. Limited or restricted movement of the toe and foot can also indicate the formation of a bunion. The limited movement can also be the result of hammer toes, which result from tight tendons and toe joints in the foot. The shape of the joint can cause difficulty when wearing regular shoes on a daily basis and can also cause a sense of numbness in the affected toe.

Causes of a Bunion

There are a number of bunion causes that exist. First, wearing tight shoes can cause or worsen pre-existing bunions. They can develop as a result of one’s foot shape or even a medical condition, like arthritis. The way in which one walks as well as the pressure they put on their feet when walking can cause a bunion to develop gradually. Standing for long periods of time can also worsen existing bunions. Bunions can also be hereditary, where individuals often inherit foot shapes that are more likely to develop bunions over time.

Risk Factors

Although anyone can develop bunions, there are a number of bunion risk factors to keep in mind. One may be more likely to develop a bunion if they have a history of bunions in their family that result from specific foot shapes. One who is flat-footed is also more likely to develop bunions. Foot injuries and inflammatory diseases, such as rheumatoid arthritis, can put one more at risk for developing bunions as well. The type of shoes one wears can also be a risk factor for bunion development, for high heels, narrow, tight, and/or pointed shoes can force crowding among the toes, thus putting the feet at risk for bunions.

When to See a Doctor

Bunions typically do not require specific medical treatment. However, it is important to seek medical care from your doctor or one who specializes in feet, such as a podiatrist or an orthopedic foot specialist. Reasons to see a doctor include but are not limited to a bump on your big toe joint or little toe joint, continuous pain in the big toe or anywhere on the foot, limited mobility of the toes or foot, and inability to fit the foot into shoes that once fit properly due to the presence of a bump on the toe joint, and inability to walk freely and normally.

How are Bunions Diagnosed?

Bunions usually start out small and get worse over time. Your doctor will diagnose the bunion through a number of different ways. They will perform a physical examination of the foot and may also suggest getting an X-Ray. The doctor will normally be able to diagnose the bunion based on the symptoms and the physical examination. During the X-Ray, the doctor will access images of bone and joint structures that will show the positioning of the toes and damage to the joint. The X-Ray will also give answers to any arthritis concerns as well as the severity of the bunion.

Bunion Treatment Options

When you visit Hicksville Physical Therapy, our doctors offer treatment and support to help your condition heal. Bunions can be treated both non-surgically and surgically.

Non-Surgical

Bunion pads and taping are over the counter remedies that are used to cushion the affected area and relieve pain. In doing so, the foot can be kept in the correct position to eliminate crowding and pain near the joint.

Correct footwear is another option for treatment. Choosing shoes with wide toe boxes can eliminate crowding on the toes and ensure that there is space between the big and second toe. Shoe inserts can also be used to help with alignment problems that cause the development of bunions.

Pain relievers are also effective treatment options. Oral and topical nonsteroidal anti-inflammatory drugs can help reduce the pain and swelling of a bunion, especially when combined with an ice pack.

Steroid injections can also be used to reduce pain and swelling of the bunion. It is important to seek proper care when considering steroid injections, for too many injections or wrong positioning of the injection can be harmful.

One of the most effective and common treatment options is physical therapy. Physical therapy for bunions comes in the form of massage, physical movement, and ultrasound therapy. This works to break up soft-tissue adhesions and lessens pain and inflammation that comes from the bunion. This joint improvement occurs over time and through the performance of physical therapy exercises. These exercises help to regain muscle around the bunion, thus working to improve alignment of the affected area. At Hicksville Physical Therapy, we offer physical therapy services in Nassau County and Long Island.

Surgical

Surgery may be considered to correct bunion complications if non-surgical treatment options are not effective. A bunionectomy is a procedure where the bunion is removed and the bones are realigned in order to correct the positioning of the big toe.

Bunion Prevention

Bunions can be prevented through the wearing of proper footwear that does not squish the toes or cause any crowding at the front of the shoe. For flat-footed individuals, shoe inserts can be worn to lessen the chances of bunion development.

If you suspect that you have signs or symptoms of a bunion, please see your doctor for further evaluation and to learn more about bunion treatment options. For more information, contact Hicksville Physical Therapy today.

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