A bunion is a bony prominence from the realignment of the joint at the base of the big toe. Bunions of the foot can take its starting point from several structures on foot.
Bunion symptoms can usually be described as the classic signs of inflammation. The ball of the foot hurts, especially under stress, and is swollen. Besides, there is often a distinct redness and overheating. Due to the pain and somewhat unpleasant feeling of tension caused by the swelling, movement is restricted.
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Causes of bunions
Many factors can lead to an inflammation of the base of the toe. Wearing wrong shoes or frequently walking in high heels leads to incorrect loading of the foot and consequently, to bunions. Malformations such as a splayfoot can also be the cause of bunion inflammation. The reason for this is also incorrect weight-bearing. In addition to incorrect loading, simple overloading of the foot can also lead to an inflammatory reaction. Here, obesity (adiposity) should be mentioned, where the heavyweight on the legs and feet places considerably more strain on the feet than is intended. In the context of gout, joints can also be affected by deposits and then react with an inflammation.
Furthermore, underlying diseases such as rheumatoid arthritis can also trigger an inflammation of the foot. Injuries and trauma can also lead to inflammation, mainly if insufficient cleaning and treatment of open injuries are provided. An inflammation can be triggered by bacteria, viruses, or fungi that have been introduced in any way.
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Therapy of bunions
The therapy of bunions depends on its cause. If wrong footwear is found to be the cause, it must be avoided at all costs. Until the inflammation subsides, general measures against inflammation such as anti-inflammatory and pain-reducing ointments and cooling of the foot are recommended. A bandage can be used to support the foot in case of incorrect or excessive strain. If there is an underlying disease, the focus is on its therapy. In the case of obesity, weight reduction is the primary goal of treatment, as this is the only way to provide the foot with meaningful relief. Rheumatoid arthritis is primarily treated with so-called essential therapeutics or DMARDs (=Disease Modifying Antirheumatic Drugs) such as methotrexate. If bacteria are the cause of the inflammation, antibiotics are used.
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Diagnosis of bunions
Like any examination, the diagnosis of bunions begins with an anamnesis interview, which is followed by a physical examination. The doctor needs to know how the complaints express themselves and how severe they are, at what time and in what situation they first appeared, and how they have developed since then. During the physical examination, the examiner palpates the ball of the foot and especially the metatarsophalangeal joints of the toes and checks for swelling, pressure pain, and overheating. He will also carefully test the mobility. Following this, an X-ray of the foot is often taken, paying particular attention to the structures around the base of the toe, to obtain indications of possible damage. Special blood tests can confirm suspected inflammation using so-called inflammation parameters, which include white blood cells (leukocytes), the C-reactive protein (CRP), and the blood sedimentation rate (BSG). In rheumatoid arthritis, so-called rheumatoid factors are often also found, and in gout, elevated uric acid levels in the blood can be detected. A computer tomography or a magnetic resonance tomography can locate the site of the inflammation. If these examinations are not sufficient for a diagnosis, tissue samples can be taken for further diagnosis if necessary.
Prognosis and prophylaxis
The prognosis depends on the type and cause of the inflammation as long as the inflammation is in the acute stage and is treated in time.
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