Bunions

A bunion is characterized by the lateral deviation of the first metatarsal leading to a deformity of the metatarsophalangeal (MTP) joint, presenting itself as a bump on the base of the big toe and the big toe being bent towards the other toes. In children, it is known as Juvenile Hallux Valgus. Since kids are more physically active than adults and their little feet are trapped in shoes most of the time, it is very likely that their MTP joints are under pressure and that can lead to bunions.

The etiology and course of this deformity have not yet been clearly understood, but different measures can be taken to manage and treat this condition.

Management and Treatment

Symptoms of bunions can be relieved in numerous ways. The first and foremost trick is applying ice for about 10 minutes or wrapping a cold cloth around the specific region of the foot to reduce inflammation.

Pediatric podiatrists recommend wearing appropriate-fit shoes that are neither narrow nor have high heels. Kids and even adults are advised to wear shoes with soft soles and wide toe boxes. In addition, professionals prescribe orthotic devices (these are custom-made or over-the-counter shoe inserts) that can straighten the big toe. You can also place a spacer between the big toe and the second digit. Some people find relief by wearing a splint at night to keep the big toe straight.

Kids with hallux valgus can also opt for bunion pads that are available at drugstores and shoe stores; they protect the bunion from extra pressure and cushion it to ease the pain. Some parents find it helpful to use medical tape around their child's bunion because the tape doesn't normally get lost and it also keeps the foot in the correct position.

Applying Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) combined with ice packs plays a significant role in relieving pain and swelling. You should consult with a pediatrician first to make sure if you can give oral NSAIDs to your child or if you should stick to topical NSAIDs. Furthermore, steroid injections are also considered part of treatment as they reduce swelling and pain, too. However, they should not be used too often because they can do more harm than good to children.

Physical therapy is one of the most reliable conservative methods in treating and managing symptoms of bunions. Massage and ultrasound therapy have been shown to break up soft tissue adhesions to reduce inflammation and pain. Physical therapy can also improve the strength of the muscles surrounding the bunion and enhance alignment.

Lastly, if non-surgical methods don't work, you may have to opt for surgery. The process includes the removal of the bunion and realignment of bones to bring the big toe back in the right position. Children should be reassured that the procedure (known as bunionectomy) is not a dangerous one and once the surgery is done, they'll be able to walk and run without experiencing any pain.