Angelic Suyama
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What Are The Main Causes Of Hallux Valgus?

Overview
Bunions Hard Skin
A bunion, also known as hallux valgus, is a painful deformity that develops at the base of the big toe. Bunions are caused when the big toe pushes and bends inward towards the other toes. This displaces the bones of the joint, causing it to protrude in a way that looks like a large growth. Bunions develop due to a variety of factors. Some people inherit feet that are more susceptible due to their shape and structure, having flat feet for instance. But bunions can be made worse by the wrong shoe, or by carrying extra weight or prolonged periods of standing or walking.

Causes
Bunions are not inherited, but do tend to run in families. What is inherited is the poor or faulty foot type, that mechanically can lead to the instability around the joint that will eventually lead to bunions, how soon, how quickly and how bad they are or become is assumed to be very dependant on the footwear. A number of other factors are known to play a role in the cause of bunions and hallux valgus. Bunions can follow foot injuries and develop in those with neuromuscular problems. Those with flat feet or pronated feet appear to be more prone to the instability about the joint and have a higher incidence of bunions. Some activities (eg ballet dancing) puts added pressure on the joint and may increase the chance of bunions developing.
SymptomsBunions or hallux valgus tend to give pain predominantly from the metatarsal head on the inner border of the foot. The bunion tends to be painful mainly when in enclosed shoes and so is often more symptomatic in winter. As the front part of the foot splays and the great toe moves across towards the 2nd toe a bunion can also produce pain from the 2nd toe itself. The pain which a bunion produces on the 2nd toe is either due to direct rubbing between the great toe and the 2nd toe, a hammer toe type deformity produced due to crowding of the 2nd toe by the bunion and the 3rd toe.The hammer toe will either be painful from its top aspect where it rubs directly on shoe wear or its under surface in the area of the 2nd metatarsal head. This is made prominent and pushed to the sole of the foot by the 2nd toe rising upwards and driving the metatarsal head downwards.

Diagnosis
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.

Non Surgical Treatment
Follow the advice given by a Podiatrist. Use felt pads to help keep pressure off the painful area of the bunions. Wear shoes that are wide and deep to accomodate the bunions. Fitting of footwear is very important. Avoid the use of high heel shoes. Use exercises to keep the joint mobile. Night splints may help with the bunion symptoms. The aim of these are to hold the toe in a more correct position. Padding or foam between the big toe and the second toe is sometimes recommended, it should, generally, not be recommended as the big toe is usually so strong it just further 'squeezes' the lesser toes and can lead to problems between these toes. The padding between the two toes will not straighten the big toe. However, sometimes the padding may be needed to help with symptoms that originate inside the joint if the bunion is painful.
Bunions Hard Skin

Surgical Treatment
A bunion is considered moderate when it pushes against the second toe. In fact, over time, the big toe can force itself under the second toe, causing it to buckle and form a "hammer toe." If non-invasive treatment is not effective, and the joint is still causing discomfort, the doctor may suggest a bunionectomy to realign the big toe. With this procedure, the bunion head is moved over realigning the angled great toe joint back to a normal position. The tendons and ligaments are also balanced for a more normal pull on the toe. In moderate bunion cases, you will experience a relatively rapid recovery. The procedure allows for immediate weight on the foot in a boot and return to tennis shoes in about a month. The choice of procedure best for each patient depends on the deformity size, the stiffness of the 1st metatarsal and the ease of realignment of the 1st metatarsal during the clinical exam.

Prevention
The best protection against developing bunions is to protect and care for your feet every day. Avoid tight and narrow-fitting shoes. Limit your use of high heels. Wear comfortable shoes with adequate space between your longest toe and the end of the shoe. Getting treatment for very flat or very high-arched feet (if you are experiencing symptoms) will give your feet the proper support and help maintain stability and balance.