bunion most commonly affects the big toe joint. They develop when the big toe shifts laterally and impinges upon the second toe and rotates in a counterclockwise direction. Retrograde pressure of the big toe results in prominence of the bone along the inside of the foot. Symptoms from a bunion may include shoe pressure on the prominent bone or bump pain. Also painful calluses, hammertoes, ingrown toenails or pain in the ball of the foot may occur.

Various factors may lead to the development of bunion deformities. Poor or tight fitting shoes may contribute. Family history is frequently contributory, as well as altered biomechanics. The deformity does tend to progress and increase in severity with time.

Initial treatment is primarily conservative and aimed at symptomatic relief. It includes wider and good fitting shoes, anti-inflammatories, lifestyle modification or padding. Surgery may be required in a bunion deformity and is reserved for cases where the symptoms are not controlled by conservative means.

Degenerative, or osteoarthritis, is the most common type of arthritis in the foot and ankle. Symptoms of arthritis tend to start slowly but often steadily increase over a period of months to years. They may include anything from stiffness in the morning, aching and throbbing, swelling around the joint and overt pain. Movement of the joint frequently becomes limited if bone spurs form around the joint. Causes of osteoarthritis in the foot include trauma, wear and tear and misalignment of the foot/joints.

Treatment is initially aimed at reducing pain. It may include ice, anti-inflammatory medications or cortisone. Stiff shoes or inserts may limit symptoms by reducing movement of the involved joint. Surgery is indicated if symptoms begin to limit patient activities. Surgery may include trimming or shaving bone spurs, realigning the joint, joint fusion or implants.