What comes to mind when you think of the word 'bunion'? I know that before I knew better (as a child), I assumed it was a condition of the foot that caused them to smell bad - it does afterall rhyme with onion, right? In all seriousness, I have learned about and treated a great many things that people referred to as a bunion. The word itself is derived from latin, 'bunio' means turnip. This term was used simply because it described that appearance of an protuberence (AKA bump) seen on the foot. Some will use the term interchangeably when describing a bump in the area of the big toe and the medical terminology encompassing this description can be any of the following: hallux valgus, bursitis, ganglion, gouty arthropathy, or even hallux limitus. Each of these conditions that can commonly be referred to as a 'bunion' are discussed below, followed by a brief discussion of why these conditions are not all treated the same - why 'not all bunions are created equal.'
- Hallux valgus is the most common condition associated with the term bunion. Hallux is the latin term for the big toe and valgus is a description of the toe's position as it tilts out toward the other toes. This results in a prominence or bump on the inside of the big toe joint and this condition can be present in many levels of severity. It is caused by altered mechanics of the foot while walking and also genetics. This condition can sometimes be complicated further in instances where a person has laxity or looseness of the ligaments in the foot and this can even put strain on other joints in the foot. If you are wondering if bunion surgery is right for you or if surgery is very painful, read here.
- Bursitis is a general term used when there is irritation and inflammation of a bursa. Bursae (the plural term of bursa) are fluid-filled sacs that are located many different places within the body, where cushioning or space is needed. There are bursa that occur routinely in certain areas of the body and occasionally the body will create these bursae in areas of irritation in order to protect the underlying anatomy. When a person has bursitis that they are referring to as a bunion, it can be a reversible irritation of the bursa and usually is treated conservatively.
- A ganglion in a benign, fluid-filled cyst that typically arises from joints or tendon sheaths (the wrapping around tendons). This is different from a bursa because it is not normally present in one's anatomy. These cysts can change size and sometimes even shape, depending on the amount of fluid within the cyst. They are not always painful, but when they are, there are many different ways to treat them.
- Gouty arthropathy (a mouthful, I know) is a condition where gout causes damage to a joint. Gout is a condition caused when the level of uric acid in the body becomes higher than normal and it deposits into the tissues around certain joints. The acid then crystallizes and causes a lot of pain and swelling. Gout is a condition that may "come and go" - especially if not treated appropriately, and the more often a person has flare ups, the more damage that can occur to the joint and the more crystals can deposit in the joint. How do you know if you have it?
- Hallux limitus is a condition that is caused by altered mechanics of walking and can be genetic or due to a traumatic insult, such as repeatedly jamming the toe. This condition describes degenerative joint disease or arthritis specifically of the big toe joint. Hallux limitus translates from latin to mean that there is limited motion (limitus) of the great toe (hallux). If diagnosed early, treatment options can be simple and non-invasive. The reason that some people describe hallux limitus as a bunion is because of the prominence that can result at the top of the big joint, due to repeated jamming which causes the bone to react and grow and be more prominent.
As you can see from the above information about various conditions of the big toe joint that can be referred to as a "bunion," they are very different. Because of this, careful evaluation by a podiatrist is required to assess what your specific condition is and how to effectively treat it if you have pain. Even within the categories of hallux limitus and hallux valgus, there are many stages to these conditions and therefore not even every "hallux valgus" is treated in the same fashion. If you have a bump on your big toe joint that is bothering you, make an appointment to see one of our doctors today!
For more information about bunions, watch our video!