Bunion Of The Big Toe

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Bunion of the big toe

Bursitis of the big toe is a consequence of a specific hallux valgus, in which there is a gradual curvature of the big toe outward. It can be argued that this pathology is determined from a genetic point of view, although this is far from the only factor in its formation.

So, the risk group includes those who, by the nature of their activity, have to stay on their feet for a long time. This is especially true for ballerinas, who spend almost all their time in rehearsals and use their toes during dancing.

Content:

• Symptoms of bunion bursitis
• Bunion causes
• Bunion bursitis treatment

Symptoms of bunion bursitis

Due to the growth of the bursitis of the big toe and periodic irritation, the cells of the articular capsule of the first metatarsophalangeal joint become inflamed. A fluid called exudate begins to accumulate in the joint cavity. Over time, the exudate may well undergo suppuration.

All this happens when accompanied by symptoms such as:

• painful sensations;
• anemia;
• loss of confidence while walking and other gait disturbances. The insidiousness of this pathology lies in the fact that initially painful sensations and gait disturbances are not too noticeable, and the patient does not attach particular importance to them.

However, it is quite easy to carry out an independent diagnosis of the presented ailment, for this you just need to squat down and take several steps in the starting position. The resulting pain in the big toe indicates bursitis.

Later symptoms are as follows:

• not only a change in shape, but also a curvature of the thumb;
• painful sensations of a wavy nature. They appear exclusively at those moments when the bursa begins to become inflamed (that is, the articular bag or the sac around the joint, which is filled with fluid);
• problems appear in the process of wearing shoes (old shoes are uncomfortable and even small);
• calluses are formed directly on the bump, which can bring painful sensations in the later stages.

All this is evidence that the bunion is at the very last stage of its formation.

The symptoms of the final stage of bursitis are as follows:

• the appearance of a purulent bursitis as a result of inflammation of the bag;
• incessant pain, not only while walking, but also in a static position.

From a physiological point of view, the symptoms of the presented disease are as follows:

• there is a deviation of the big toe to the outer part, as a result of this, the front part of the foot changes its shape, which means that there is a violation of shock absorption;
• as the disease develops, the cartilage begins to ache, a specific arthrosis of the joints of the metatarsophalangeal region is formed and a permanent bursitis is formed;
• the top of the primary metatarsal bone begins to grow ("bones" on the first toes in the foot area);
• the flatness of the foot is manifested, which is characterized by a cross flow;
• painful sensations are formed in the soles of the feet near the pommel of the primary metatarsal bone;
• deformities of the cross-type arch of the foot are formed;
• the pressure is transferred to the tops of the middle metatarsal tissues, that is, their significant overload occurs;

• in the plantar region of the foot, not only calluses begin to form, but also calluses, which significantly complicate the walking process due to sudden and sharp painful sensations.

Bunion causes

Bursitis of the big toe is formed due to the accumulation of excess fluid, which is sometimes purulent, in the synovial type bag.

This may be preceded by such reasons as:

• bruises in the area of this part of the foot;
• lack or excess of calcium;
• minor injuries that do not heal over a long period of time;
• poor-quality or uncomfortable shoes (narrow, made of hard material);
• flat feet (acquired or congenital, which is neglected and has never been treated);
• deformity of the foot obtained at birth;
• allergic reactions (occur quite rarely, mainly when changing the place of residence, for example, from Europe to Africa);
• diseases of an autoimmune nature (regardless of the type, they can affect the bursitis of the big toe only if timely prevention is not carried out);
• destabilization of all metabolic processes;
• intoxication processes;
• infection.

The main and most common reasons should be considered the first five points, all subsequent ones are quite rare or are quite specific. Inflammatory processes that cause bursitis of the big toe may well spill over from the tissues located in the neighborhood, if a powerful inflammatory process is observed in that area.

Another reason is diseases that, over time, lead to the destruction of joint tissues:

• arthritis;
• psoriasis;
• rheumatism.

If we consider this problem from a physiological point of view, then two violations of biomechanical processes lead to the formation of the presented pathology, such as:

• combination in violation of the ability to move;
• excessively high degree of mobility of the primary metatarsal bone.

In the case when both of the above abnormalities are simultaneously present in the anamnesis, the joint of the big toe is exposed to excessive pressure precisely at the stage when the limb is ready to push off the ground. Wherein:

• the muscles and tendons of the thumb must be stretched in order to resist tension, and also in order to create limitation of motor skills and the degree of joint mobility;

• being in such a stretched position causes the big toe to bend outward so that the tip of the toe points towards the outermost toe;
• all parts of the thumb press on the first metatarsal bone, and it also begins to shift outward.

As a result, the proximal phalanx and metatarsal bone form a formation that resembles an arch. Thus, bunion is a slowly progressive disease that occurs in several stages. That is why it is very important to carry out adequate and timely treatment. Because any ailment is much easier to treat at an early stage than at a later stage.

Bunion bursitis treatment

The process of treating bursitis of the big toe must begin with hygienic measures. Choosing the right footwear will greatly reduce the stress on the big toe. As part of this, it is advisable for female representatives to abandon "boats" and all high-heeled shoes. In case of deformities of the big toe, it is desirable to wear specific shoes with orthopedic insoles and soft pads located in the area of the big toe.

By itself, bursitis should be treated with anti-inflammatory ointments and gels, for example, "Voltaren emulgel". When an accumulation of exudate occurs in the articular cavity, specialists carry out puncturing, that is, a puncture. After that, the exudate is sucked out, and Kenalog or some other steroid-type hormone is injected into the articular cavities. The goal remains the same - to neutralize inflammation. If there are infectious complications of bunion bursitis and pus begins to accumulate, it is necessary to take antibiotics.

During the recovery period, it is necessary to carry out physiological procedures, such as electrophoresis, paraffin treatment, ozoknerite. Although in the presented case, such treatment is assigned an exclusively auxiliary role. At the same time, when the bursitis of the big toe is only a complication of another ailment, the treatment of this disease is carried out in a whole complex of procedures.

The most common recovery scenario is as follows:

• a special plaster is applied to the patient, which fixes the required joint;
• the necessary medications are prescribed, most often we are talking about anti-inflammatory drugs;
• there is a need for rest in a home or hospital. At the same time, any physical work and stress associated with sports is prohibited. Exercise therapy is acceptable, where exercises will be carried out in agreement with a specialist;
• in the most advanced cases, it is advisable to carry out a course of antibiotics, which will take place separately or together with hormonal drugs, which is determined depending on the stage and severity of the disease;
• after a few days, UV radiation, UHF therapy is prescribed, and compresses from alcohol are prescribed.

In more difficult cases, when the bursitis of the big toe is started to purulent, surgical intervention may be necessary. In this case, the pus is removed by surgery.

Indications for surgical intervention for bursitis can be:

• low efficiency in the implementation of conservative treatment;
• change in the nature of painful sensations to a stronger one;
• change in the valgus angle in size;
• aggravation of violations in time.

Bursectomy should be considered the simplest and least traumatic method. As part of this operation, the bone growth is removed and, if necessary, the hypertrophied area of the metatarsal bone. To do this, an incision must be made in the area of the build-up. Through it, with the help of a surgical electric knife, excess bone tissue is removed.

In the same case, when the bursitis of the big toe is started, plastic surgery of this area is performed using osteotomy. As part of the operation, a certain number of deep cuts are made, both on the big toe and on the back of the foot. After that, according to a certain method, the bone tissues of the finger and the primary metatarsal bone are moved. Those bones that have been displaced are fixed with metal structures. The purpose of this method of treatment is to eliminate, or at least reduce the hallux valgus.

For the next six to eight weeks, careful care of the foot area is required - wearing comfortable and not tight shoes, cleaning not just the wound itself, but also the area around it. It is also advisable to avoid moisture and hypothermia.

In some cases, doctors prescribe a course of calcium treatment. This reason for the formation of bunion bursitis is quite rare and can be easily dealt with if you start to use drugs with a high calcium content in time. In the case when there is an excess of this substance in the body, we are talking about how to remove it or compensate for other elements.

When the disease is caused by a calcium deficiency, it progresses very quickly, but if there is a lot of it, then, on the contrary, for a long time. This is due to the chemical processes that occur in the human body. Therefore, replacement therapy, as well as the study of not only hormonal levels, but also general blood and urine tests should be taken every six months.

After the treatment is carried out, for the rest of his life the patient will need to wear special shoes, do simple exercises every day and monitor the level of calcium.

One should not neglect the norms of prevention of the presented disease. They boil down to avoiding the reasons that initially contributed to the development of the disease, as well as, in general, not to allow wearing uncomfortable shoes, heal wounds on time, remember about foot hygiene, and avoid unnecessary physical stress.

Author of the article: Kaplan Alexander Sergeevich | Orthopedist

Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.