It s a bony bump that forms on the joint where your big toe meets your foot -- called the metatarsophalangeal (MTP) joint. It happens slowly over time, and eventually gets bigger and sticks out. It can make your big toe turn in, sometimes so far that it moves on top of the toe next to it. This deformity is progressive and will increase with time although the symptoms may or may not. The enlarged joint can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis), leading to additional swelling, redness, and pain. A less common bunion located at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor's bunion or bunionette.
Causes of bunions Issue No 165: Dated 1st Feb 2018 While the precise cause is not known, there seem to be inherited (genetic) factors that lead to abnormal foot function, such as overpronation that can predispose to the development of bunions. Abnormal biomechanics can lead to instability of the metatarsal phalangeal joint and muscle imbalance resulting in the deformity. Although shoe gear doesn't directly cause a bunion, it can certainly make the bunion painful and swollen. Other less common causes of bunion deformities include: Trauma (sprains, fractures, and nerve injuries), Neuromuscular disorders (polio or Charcot-Marie-Tooth disease), Limb-length discrepancies (one leg shorter than the other) where the longer leg develops the bunion. The longer limb will tend to cause the foot to overpronate. Who develops bunions? Bunions most commonly affect women. It has been suggested that tight-fitting shoes, especially high-heel and narrow-toed shoes, might increase the risk for bunion formation. Tight footwear certainly is a factor in precipitating the pain and swelling of bunions. Other risk factors for the development of bunions include: Abnormal formation of the bones of the foot at birth (congenital) arthritic diseases such as rheumatoid arthritis In some cases, repetitive stresses to the foot can lead to bunion formation (eg. ballet dancers)
Symptoms and Signs of a bunion Bunions may or may not cause symptoms. A frequent symptom is foot pain in the involved area when walking or wearing shoes; rest and/or change to a wider shoe relieves this pain. Shoe pressure in this area can cause intermittent pain while the development of arthritis in more severe bunions can lead to chronic pain. Besides ill-fitting shoes, unsupportive flimsy soled shoes can add stress to the bunion joint and increase pain and instability to the area. In post-pubertal men and post-menopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that is similar to the pain caused by bunions. How to diagnose a bunion? A physician will consider a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position (weight-bearing).
Treatment for bunions Nonsurgical treatments such as rest and wearing loose (wider) shoes or sandals (preferably with a supportive sole) can often relieve the irritating pain of bunions. Walking shoes may have some advantages, for example, over high-heeled styles that pressure the sides of the foot. Anti-inflammatory medications can help to ease inflammation as well as pain. Local cold-pack application is sometimes helpful, as well. Bunion shields or pads can reduce pressure on the bunion. Depending on the structure of the foot and severity of the bunion, custom insole orthotics can slow the progression of the bunion and address underlying biomechanical causes such as over-pronation. Constant pressure or friction can lead to skin breakdown and infection that may require antibiotic therapy. When the measures above are effective in relieving symptoms, patients should avoid irritating the bunion again by optimizing footwear and foot care. For those whose bunions cause persisting pain, a surgical operation is considered for correction of the bunion. The surgical operation to correct a bunion is referred to as a bunionectomy. Surgical procedures can correct deformity and relieve pain, leading to improved foot function. These
procedures typically involve removing bony growth of the bunion while realigning the big toe joint. Is it possible to prevent bunions? If the diagnosis is made early on, such as in preadolescence, bunion development can be slowed and, in some cases, arrested with the proper supportive shoe gear and custom functional shoe inserts (orthotics). Avoidance of certain athletic activities with improper shoe fit and toe pressure can prevent the symptoms that occur with bunions. What is the prognosis of a bunion? The treatments described above are very effective in treating bunion deformities, and the prognosis can be excellent. However, the correct diagnosis is essential to define any underlying associated deformities as well as the bunion severity. Also, a bunion is a progressive deformity and will get worse with time. It can cause instability to the rest of the foot and sometimes lead to arthritis in the joint at the base of the big toe. It is, therefore, advised to consult with a foot specialist to fully evaluate a bunion.
What Causes Excessive Yawning? Yawning is a mostly involuntary process of opening the mouth and breathing in deeply, filling the lungs with air. It is a very natural response to being tired. In fact, yawning is usually triggered by sleepiness or fatigue. Some yawns are short, and some last for several seconds before an open-mouthed exhale. Watery eyes, stretching, or audible sighs may accompany yawning. Yawns may have common triggers include fatigue and boredom. It can also occur when you talk about yawning or see or hear someone else yawn. It is believed that contagious yawning may have something to do with social communication.
Excessive yawning is yawning that occurs more than once per minute. Although excessive yawning is usually attributed to being sleepy or bored, it may be a symptom of an underlying medical problem. Certain conditions can cause a vasovagal reaction, which results in excessive yawning. During a vasovagal reaction, there is increased activity in the vagus nerve. This nerve runs from the brain down to the throat and into the abdomen. When the vagus nerve becomes more active, heart rate and blood pressure drop significantly. The reaction can indicate anything from a sleep disorder to a serious heart condition. Causes of Excessive Yawning The exact cause of excessive yawning isn t known. However, it may occur as a result of: drowsiness, tiredness, or fatigue sleep disorders, such as sleep apnea or narcolepsy side effects of medications that are used to treat depression or anxiety, bleeding in or around the heart Although less common, excessive yawning could also indicate a brain tumor a heart attack, epilepsy, multiple sclerosis, liver failure, body s inability to control its temperature Diagnosing Excessive Yawning To identify the cause of excessive yawning, your doctor may first ask you about your sleep habits. They will want to make sure that you are getting adequate restful sleep. This can help them determine whether your excessive yawning is occurring as a result of being fatigued or having a sleep disorder.
After ruling out sleep issues, your doctor will perform diagnostic tests to find another possible cause for excessive yawning. An electroencephalogram (EEG) is one of the tests that may be used. An EEG measures the electrical activity in the brain. It can help your doctor diagnose epilepsy and other conditions affecting the brain. Your doctor may also order an MRI scan. This test uses powerful magnets and radio waves to produce detailed images of the body, which can help doctors visualize and assess bodily structures. These pictures are often used to diagnose spinal cord and brain disorders, such as tumors and multiple sclerosis. An MRI scan is also beneficial for evaluating the function of the heart and detecting heart problems. Treating Excessive Yawning If medications are causing excessive yawning, your doctor may recommend a lower dosage. Make sure to discuss this with your doctor before making any changes to your medications. You should never stop taking medications without approval from your doctor. If excessive yawning is occurring as a result of a sleep disorder, your doctor may recommend sleep-aid medications or techniques for getting more restful sleep. These may include: using a breathing device exercising to reduce stress adhering to a regular sleep schedule If excessive yawning is a symptom of a serious medical condition, such as epilepsy or liver failure, then the underlying problem must be treated immediately.
Disclaimer: Content is sourced from public domain & is provided by H3U for educational & informational purposes. It should not be considered as a substitute to medical advice. H3U makes every effort to ensure accuracy or completeness of editorial content, However we do not take responsibility for any errors, omission & also do not take responsibility to ensure that data, information of material is kept up to date. The views expressed in these articles are not necessarily those of H3U. Reproduction, modification, storage in a retrieval system or retransmission, in any form or otherwise, for reason other than educational & for informational purposes are strictly prohibited without prior written permission of H3U. Corporate Office Vipul MedCare Pvt Ltd. 534, Udyog Vihar, Phase V, Gurgaon, Haryana 122016 Phone: 91-124-4236301, Fax: +91-124-4236303, E-mail: info@vipulmedcare.com