The term "hallux valgus" or "hallux abducto-valgus" are the most commonly used medical terms associated with a bunion anomaly, where "hallux" refers to the great toe, "valgus" refers to the abnormal angulation of the great toe commonly associated with bunion anomalies, and "abductus/-o" refers to the abnormal drifting or inward leaning of the great toe towards the second toe, which is also commonly associated with bunions. It is important to state that "hallux abducto" refers to the motion the great toe moves away from the body's midline. Deformities of the lower extremity are usually named in accordance to the body's midline, or the line bisecting the body longitudinally into two halves. In more severe cases, the hallux continuing in the abductus fashion eventually either overlaps or underlaps subsequent lesser (small) toes especially the second (adjacent toe).
The main cause of bunions is excessive pressure being placed on the front of the foot, and is usually the result of wearing high-heeled shoes with pointed toes. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the United States wear shoes that are too small and that 55 percent of them have bunions. Overall, bunions are nine times more common in women than men. In some cases, bunions are hereditary; they also may be caused by arthritis or polio.
While bunions may be considered cosmetically undesirable, they are not necessarily painful. In cases where the individual has minor discomfort that can be eased by wearing wider shoes made of soft leather and/or with the aid of spacers-padding placed between the toes to correct alignment-further treatment may not be necessary. (Anti-inflammatory agents can be used to alleviate temporary discomfort at the site of the bursa.) For those who continue to experience pain on a daily basis and who cannot wear most types of shoe comfortably, surgical treatment may be the best choice.
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI's are not usually required.
Non Surgical Treatment
The treatment of bunions should be individualized because the degree of deformity is not always consistent with the degree of pain. The most important first step in the treatment (and prevention) of bunions is to wear properly fitted shoes, with a low heel and adequate room in the toe area. Further treatment may include relative rest and icing to decrease pain around the MTP joint, medications to reduce inflammation and pain, stretching and strengthening exercises and shoe orthotics. If the above measures are not successful, surgery may be required.
Surgery isn't recommended unless a bunion causes you frequent pain. A bunionectomy, like other types of surgery, is not without risk. Additionally, you may still have pain or you could develop a new bunion in your big toe joint after surgery. Consider trying conservative treatment before having a bunionectomy.If you have an underlying mechanical fault,surgery will only correct the aesthetical nature of your bunion for a short period.So therefore surgery is not recommended.