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What Leads To Pain Under The Heel And How To Eliminate It

Plantar Fascia

Overview

Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.




Causes

Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if your feet roll inward too much when you walk ( excessive pronation ). You have high arches or flat feet. You walk, stand, or run for long periods of time, especially on hard surfaces. You are overweight. You wear shoes that don't fit well or are worn out. You have tight Achilles tendons or calf muscles.




Symptoms

Plantar fasciitis is usually found in one foot. While bilateral plantar fasciitis is not unheard of, this condition is more the result of a systemic arthritic condition that is extremely rare in an athletic population. There is a greater incidence of plantar fasciitis in males than females (Ambrosius 1992). While no direct cause could be found it could be argued that males are generally heavier which, when combined with the greater speeds, increased ground contact forces, and less flexibility, may explain the greater injury predisposition. The most notable characteristic of plantar fasciitis is pain upon rising, particularly the first step out of bed. This morning pain can be located with pinpoint accuracy at the bony landmark on the anterior medial tubercle of the calcaneus. The pain may be severe enough to prevent the athlete from walking barefooted in a normal heel-toe gait. Other less common presentations include referred pain to the subtalar joint, the forefoot, the arch of the foot or the achilles tendon (Brantingham 1992). After several minutes of walking the pain usually subsides only to re turn with the vigorous activity of the day's training session. The problem should be obvious to the coach as the athlete will exhibit altered gait and/ or an abnormal stride pattern, and may complain of foot pain during running/jumping activities. Consistent with plantar fascia problems the athlete will have a shortened gastroc complex. This can be evidenced by poor dorsiflexion (lifting the forefoot off the ground) or inability to perform the "flying frog" position. In the flying frog the athlete goes into a full squat position and maintains balance and full ground contact with the sole of the foot. Elevation of the heel signifies a tight gastroc complex. This test can be done with the training shoes on.




Diagnosis

Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past. The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.




Non Surgical Treatment

The good news is that plantar fasciitis is reversible and very successfully treated. About 90 percent of people with plantar fasciitis improve significantly within two months of initial treatment. If your plantar fasciitis continues after a few months of conservative treatment, your doctor may inject your heel with steroidal anti-inflammatory medications (corticosteroid). Cortisone injections have been shown to have short-term benefits but they actually retard your progress in the medium to long-term, which usually means that you will suffer recurrent bouts for longer. Due to poor foot biomechanics being the primary cause of your plantar fasciitis it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the development of a heel spur. Your physiotherapist is an expert in foot assessment and its dynamic biomechanical correction. They may recommend that you seek the advice of a podiatrist, who is an expert in the prescription on passive foot devices such as orthotics.

Heel Discomfort




Surgical Treatment

In cases that do not respond to any conservative treatment, surgical release of the plantar fascia may be considered. Plantar fasciotomy may be performed using open, endoscopic or radiofrequency lesioning techniques. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. Potential risk factors include flattening of the longitudinal arch and heel hypoesthesia as well as the potential complications associated with rupture of the plantar fascia and complications related to anesthesia.




Prevention

The best way to prevent plantar fasciitis is to wear shoes that are well made and fit your feet. This is especially important when you exercise or walk a lot or stand for a long time on hard surfaces. Get new athletic shoes before your old shoes stop supporting and cushioning your feet. You should also avoid repeated jarring to the heel. Keep a healthy weight. Do your leg and foot stretching exercises regularly.

Symptoms Of Painful toes

If your Foot Conditions feels like a bruise or a dull ache, you may have metatarsalgia People with metatarsalgia will often find that the pain is aggravated by walking in bare feet and on hard floor surfaces. Pain in the ball of your foot can stem from several causes. Ball of foot pain is the pain felt in the ball of foot region. Metatarsalgia is a condition characterized by having pain in ball of foot. The average adult takes about 9,000 steps per day.

These conditions include different types of arthritis , osteonecrosis , neuromas , tumors, or infections. Lastly, traumatic injuries, including fractures and ligament tears, can cause this type of foot pain. Treatment of foot pain often consists of anti-inflammatory medications , footwear modifications, and inserts for your shoes. When buying footwear, look for shoes with a wide toebox, good support, and avoid high heels. These pads help to take pressure off the ball of the foot. If some simple steps do not alleviate your symptoms, you should see your doctor to ensure you are receiving adequate treatment. In some rare situations, patients don't find relief with shoe modifications, and may require a surgical procedure. Remember that our shoes protect us from injury.

Those affected by inflammatory conditions such as rheumatoid arthritis and Achilles tendonitis are also likely to experience pain and swelling in the ankles. If the joints in the feet get affected by osteoarthritis, it gives rise to pain, stiffness, swelling in or around the joint, and restricted range of motion. Since pain in the feet could be caused due to a variety of reasons, the treatment will depend on the underlying cause. Many a time, pain could be experienced by people who perform high-impact exercises such as running, jogging and other sports. Those who have been experiencing pain while running must make sure that they wear a good quality footwear. Painkillers or steroids might be prescribed for the treatment of a sprained ankle.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Another solution is to wear custom foot orthotics, like ezWalker ® Performance Custom Orthotics, in your shoes to help correct your body posture, stabilize your balance, relieve pain during follow-through and evenly redistribute your weight on your feet. EzWalker® Custom Orthotics are specifically made for each of your feet to properly support your arches while reducing pressure on the balls of your feet. With ezWalker® Custom Orthotics, you'll walk from lateral heel to medial forefoot for better biomechanics of your entire body. This condition manifests as a skin lesion that assumes a ring-like pattern. It can affect any region of the body, right from the scalp to the foot. One such common home remedy is the use of bleach. Many people claim that this is a very effective ringworm treatment.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

The ezWalker® Custom Performance Insole can help relieve the pain and pressure of hammer toe by strategically supporting the medial, lateral, and trans-metatarsal arches to relieve pressure on the ball of the foot and therefore, release the action causing the hammer toe in the first place. Each ezWalker Performance Insole is custom molded to the specifications of each one of your feet, providing you with the support and comfort you need to relieve pain and produce comfort. Whether your hammer toe condition is due to genetics or not, ezWalker® Custom Performance Insoles can help you find relief from hammer toe and foot pain. The back of your ankle may feel tight and sore.

Remedy And Cure For Hammertoe, Claw Toe, Mallet Toe Prevention And Treatment

In addition, claw toes are often associated with forefoot pain (metatarsalgia) as the MTP joints commonly become subluxed in patients with pronounced claw toes. Scared to walk around in sandals because of unsightly claw toes? Around three million Britons have hammer toes, which can make walking difficult. With this deformity, the toe is bent at the middle joint causing a curling of the toe. Question: How to treat curled toes problem?

This treatment produces reduced level electrical impulses on your foot to increase the blood flow and strengthen muscles by contracting the soft tissues. They will have a flap of excess skin that sort of appearances like a "bat wing" between the 2nd and 3rd toes. If you do, have this webbing of the toes, it is a respectable tip off that you do have a short metatarsal bone and probably have a Morton's Toe. An evening splint holds the foot at 90 degrees throughout your sleep. The aim of the splints is to keep your foot and calf muscles extended throughout the night. Here is more info on feet problems have a look at the website. Generally throughout rest the plantar fascia and calf bones often tighten and shorten. So when you wake up in the morning and take your primary steps, the fascia are being pulled all of an unexpected, causing the acute pain in the heel. Consistent rubbing and friction then causes Corns and Callous to develop. Also called a claw toe or mallet toe.

Other toe pain conditions, such as toe misalignment can be easily prevented and treated with the use of good quality Orthotic Foot Beds. What usually leads to such problems include poor posture, sitting for long periods without exercise or stretching, and arthritis. As a matter of fact, a simple correction of posture can provide relief from sciatic nerve pain. Dr. Marble discusses the problem of thick toe nails and its many etiologies. If you know anybody with drug or alcohol addiction and suffering from mental problems, dual diagnosis treatment can help them. Plantar fasciitis mostly occurs in people between 40 and 60 years of age.

Therefore flat shoes are a better option during pregnancy because it will keep you comfortable avoiding complications and dangerous consequences. But, there are some women who cannot even think of wearing flat shoes. Wearing flat shoes gives them the feeling of naked feet. For them, it is better to use heels of about 2 to 3 inches maximum. Common types of crooked toes are hammer toes, claw toes, and mallet toes.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

When a bunion worsens, it may cause associated problems in the so-called lesser toes, such as hammer toes, claw toes and crossover toes, said Dr Tan. More than 50 per cent of the time, people with lesser toe deformities have an underlying reason - that is, bunions,” said Dr Tan. One such deformity is the hammer toe, so-called because the abnormal bend at the middle joint makes it look like one. There is also the crossover toe, which, as the name suggests, occurs when one toe crosses over another. This is a toe that is bent upward from the joint at the ball of the foot and downward at the middle joint towards the sole, such that it resembles a claw. Before claw toes develop, most patients have pain under the ball of the foot.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Emotional and physical stress from both the surgery and recovery time changes your metabolism, which increases acid production. The use of both general and local anesthesia, pain medication, anti-inflammatory medications and other medications such as antibiotics will also introduce more acid to your system, lowering the alkalinity. To maintain your body's proper pH, keep yourself well hydrated prior to and after surgery. These include: aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).Arrange for a ride home from surgery and for someone to look after you for at least the first 24 hours.Avoid long trips for at least two weeks after surgery.Avoid eating and drinking anything after midnight the night before surgery. After surgery you will receive pain medication and care instructions.

Sometimes a change in activity, shoes, or weight gain can make a bunion or hammertoe seem suddenly very painful. Orthotics, custom orthopedic foot supports, can help with mild hammer toes and bunions. Orthotics may slow down or perhaps prevent the progression of bunions and hammer toes.

Diagnosis And Treatment

Look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone. Now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together. Heel Pain can be caused by Plantar Fasciitis and Heel Spurs. Pain ranges from mild to severe and can cause other health issues if left untreated. You can treat heel pain caused by plantar fasciitis and heel spurs with a patented orthotic that uses Fascia-Bar technology to relieve pain and heal the underlying conditions. Heel spur is a very common medical condition amongst men and women in their middle age. Heel spur is caused due a hook of bone being formed on the heel bone. It is characterized by intense heel pain. The heel pain does not occur due to the formation of the hook of bone. read more Are you uncomfortable with the severe foot or heel pain in the morning, after or while walking, after sleeping, sitting or running and looking for foot heal pain treatment? You may be affected by plantar fasciitis, inflammation of plantar fascia, the ligament between the front of the heel and the base of the toes that helps to support the arch. When we sprain an ankle, for example, the pain warns us that the ligament and soft tissues may be frayed and bruised, and that further activity may cause additional injury. Night Splint - designed to keep your tendons and ligaments stretched at night to reduce heel pain throughout the day.heel pain during pregnancy And don’t think that treating pain always requires rest – my pain went away in concert with the biggest ramp-up of mileage in my life! Rest can definitely be helpful in overcoming acute pain, but it doesn’t necessarily resolve the underlying cause – you need to get at the root of the problem if you want long term resolution of the issue. Again, for more on this read Jay Dicharry’s book It forms the longitudinal arch of the foot and functions as a shock-absorber when you walk or run. Irritation or inflammation of the plantar fascia occurs primarily at its attachment to the heel bone or calcaneus. Many people complain about feet discomfort within the rearfoot area; normally, this is plantar fasciitis which is a particularly unpleasant affliction where the heel's muscle have miniscule rips near to the heel bone. Several things can cause this condition to occur including unhealthy weight gain, incorrect running methods, too-small sneakers, or excessive foot pressure. read more Tarsal Tunnel Syndrome – A large never in the back of the foot gets entrapped and the person feels heel pain There may be other causes as well for heel pain And therefore it is of utmost importance to diagnosis the cause of the problem. So make sure you visit a qualified podiatrist nearby. Living in the modern century, time is money. We think about money much more than any other thing. We need the money to pay off our expenses, our little ones and many more other things. Have you realize that we need health and wellbeing as much to be able to work well. As funds evolved into most of our main concern, we tend to neglect about taking care of our body. Overlooking the needs and condition of our body will result in us to have difficulties doing work or even walking. heel pain when walking

Identification And Treatment Of A Hallux Valgus Bunion

Hallux Abducto Valgus or Bunion pain is one of the more common foot conditions treated by DR. Marc Blatstein Dr. Marc Blatstein’s patients usually relate pain either when wearing shoes, or when there is pressure applied to the side of the big toe Bunion pain can become such that “it hurts” both in and out of shoe gear. Treatment, Dr. Marc Blatstein relates may start with a varying the types of shoegear worn during the day, padding the area around the bunion, orthotics and eventually changing the types of shoes that you wear Recently having trouble wearing shoes or walking with chronic pain on your foot? Are you limited to certain foot activities that require a lot of movements such as dancing, running, and jumping? There are various reasons why you are undergoing such discomforts. Normally, they start to occur when you reach the age of 40. They can be very uncomfortable at times, but popular remedies such as stretching and exercising using toe stretchers or gel toe separators definitely help suppress the pain in the long run. So, in theory, if you lived on a tropical island and never wore shoes your whole life you could still develop hallux valgus. Yes, my foot is under her head! So regardless what I do I have a cuddlier 24/7. You can sort of see my black and blue big toe sticking out above her head! I will admit this is one of my favorite times at the end of the day. Once the house gets quiet. I love to go put on a movie and just relax and Allie will just come and rest right next to me. So anyone who wants to anything about orthopedics right from the anatomy of bone to working of joint to treatment of fractures to oesteoporosis and arthritis i would be glad to help and advice The soft tissue covering of the foot is extremely thin, and this hampers wound healing. Furthermore, perfusion is poorest in the foot because of its distance from the heart. Finally, of all parts of the body the foot is subjected to the greatest mechanical stresses. For these reasons wound healing problems, depending on the extent of the operation and the patient’s medical history, occur more frequently in the foot than in most other regions. The aim is uncomplicated wound healing in at least 99% of patients, in our experience an attainable goal. Particular care must therefore be taken when operating on the great toe. Excessive retraction should be avoided. hallux valgus radiology Although no-one can be sure if bunion pain is caused solely by wearing heels & narrow shoes, it can definitely be prevented by using the right sort of shoes and not using any shoe that squash or crowd the toes. Bunion discomfort could be inherited or develops over time depending on the foot type and how the pressure is dispersed on the feet. However, wearing comfy footwear with a wider toe area have often assisted in relieving people of the pain and constant distress caused by the bunions. I must caution you that the use of the TightRope for bunion correction is a relatively new concept but is very promising. A successful treatment for Bunion ( Hallux Valgus ) requires a full understanding and careful characterization of each deformity component. A lot of treatments can be made available, however, the best method would be the one which specifically address the deformity. It is simple to diagnose this condition. Physicians may plainly examine the affected foot and listen to the patient's statement of what he has been feeling. Sometimes an x-ray may be required for confirmation. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15º is considered to be a sign of pathology. Medications. Anti-inflammatory drugs such as naproxen or ibuprofen may help relieve pain. ***Care should be to understand the risks and possible complications of taking anti-inflammatory medications, especially for prolonged time.*** Orthotic devices. An OTC (over the counter) orthotic or custom molded orthotic can assist in controlling poor alignment and associated instability of the foot and improve function of the big toe. Are you suffering from bunion pain? Wondering how to get relief from this pain? Scroll down to learn about the causes, symptoms and treatment of this foot condition. What are the most effective bunion treatment options? Go through this article to find out more about treating this foot abnormality. Welcome to Real Bellezza, a Peruvian Company dedicated to Cosmetic Surgery, which offers the best of Plastic Surgery in Peru. We have an excellent work team formed by surgeons, nurses and aestheticians, which supported by state-of-art specialized equipment, puts at your disposal the best advanc read more Aging is accompanied with increased risks to every organ as the biological processes of the body are slowing down. With growing age, we may lose visions, increases bone fractures, teeth decaying, falling of hairs and lots of other problems. Osteoporosis is one of those, it is a bone disorder in which bones starts deteriorating and cartilages are easily damaged. read morehallux valgus surgery It occurred once again nowadays in my workplace. A woman came in asking for bunion surgery. She had put up with the pain in her huge toe for years and finally had had adequate. Several years ago her loved ones doctor told her to wait until she couldn’t stand the pain in her foot just before discussing surgery with a podiatrist. Like numerous physicians, they assumed any pain in the wonderful toe accompanied by a bump was a “bunion” or Hallux Abducto Valgus. Unfortunately in this case, her physician was incorrect. The patient truly has Hallux Limitis also identified as osteoarthritis of the great toe joint.

Different Bunions Treatment Options

The leading cause of hangnails and ingrown toenails is clumsy nail trimming. Use toenail clippers to keep them short and file down rough edges. File nails into a shape that mirrors the curve of your nail base. After trimming, dab nails with tea tree oil, a natural anti-fungal, to help keep them healthy and clean. You’re not fully holiday ready without a good summer polish on your toe nails. I like red hues on my toes but the list is endless with colour choice and design details. A good nail varnish will vamp up your toes to look glamorous and cared-for. Assessing skin turgor (fullness) is a way for health care workers to assessthe amount of fluid loss that may occur from various conditions, such asdiarrhea or vomiting. Loss of body fluid through frequent urination also is aconcern for people with diabetes. Skin turgor refers to the skin’s elasticity(its ability to change shape and return to normal). An assessment of skin turgoris used to help determine the effects of diabetes on skin health. Can these skin problems be prevented? There are various different methods employed to re-shape the joint at the big toe, to realign the joint. Each uses a slightly different technique to achieve the same result.bunion hard skin Shoes make the outfit. We kick off our shoes or sandals when we get home. Somewhere in between putting them on and taking them off, our feet can suffer from some uncomfortable shoe side effects Do your feet ache, throb, hurt? Let’s see if we can break down what’s causing your broken down foot. Athlete’s Foot. Fungus on the foot (usually between the toes or on the bottom of the feet) that causes redness, itchiness, tiny bumps filled with fluid, or peeling skin. A common skin condition that can affect everyone, not just athletes. It is most commonly located between the toes or on the bottom of the feet. Hyperidrosis, caused by the over-activity of sweat glands, bring about swelling of the soles and toes, redness and flaking between toes. Athlete's Foot is a fungal infection that always start in the web between toes. Flaking, cracking and blistering of the skin are more severe symptoms which can be avoided. Corns or small patches of hard skin are provoked by pressure from an ill-fitting shoe and can be removed by corn caps and corn drops. Bunions - misaligned toe joints- which are swollen and painful are caused by ill-fitting shoes. A verruca is a viral infection commonly transmitted by walking barefoot on unhygienic floors. Pregnancy can sometimes cause the arch to flatten, as can a job which involves standing. So, for example, hairdressers, teachers, waiters, waitresses, nurses and the police can have problems. The same exercises will help. If shoes suddenly start to cause problems, such as corns, after several years wear it probably means that the shoes have lost their shape. Much as you may love that particular pair of shoes it is best to throw them away as they will give you pain and discomfort each time you wear them. Medications , such as nonsteroidal anti-inflammatory drugs or cortisone injections, may be prescribed to ease pain and inflammation caused by joint deformities.

Ares Kinesiology Tape

HV angles on radiographic images of 32 patients were first measured using the Pi-View Star software on a digital workstation with these values being set as the reference standard. Two attending orthopedic surgeons, blinded to the computerized measurements, utilized the iPhone running the Hallux Angles application to measure the angles on images displayed on a parallel-positioned computer monitor. Decision-making regarding the myriad surgical options to correct hallux valgus is a complex procedure involving radiographic assessment of standardized angles that define severity. When performed manually, these measurements show a great deal of variability between-and are highly error-prone. Computerized assessment is the current standard, utilizing a software program to calculate the angles. The foot is a complex structure made up of many bones and muscles. The foot has three arches that give strength and stability to the foot. The three arches are the transverse, lateral, and medial arch. The arches allow the 26 bones of the foot to move and support the muscles and ligaments that are present. According to the American Academy of Orthopaedic Surgeons, a bunion forms due to a condition known as hallux valgus. This is a Latin term that means a turning outward of the big toe. The bunion is made up of a combination of soft tissue and bone. You Might Also Like Causes. A dorsoplantar radiograph with the foot under load is required. An additional lateral or oblique view in this position contributes little extra information because the bones are superimposed, but may help to depict deformities of the smaller toes and instability of neighboring joints. Only under conditions of loading can the angle between the first and second metatarsals (intermetatarsal angle) be determined accurately. The radiograph will show the congruence of the metatarsophalangeal joint, i.e., whether a subluxation exists, and should also be inspected for any signs of osteoarthritis (joint space narrowing, subchondral sclerosis). Use an ice pack to alleviate pain, inflammation and redness associated with the bunion. Apply the ice on the joint after elevating the foot on a stool. One can also use bunion gel pads, bunion shields or bunion splints to reduce the pain and inflammation. The gel pads and shields are to be worn over the foot or applied directly over the bunion to protect the foot against pressure, friction and abrasion, while wearing shoes. The splint on the other hand is worn at night to correct the position of the toe. It can also be worn during the day while wearing shoes.hallux valgus deformity This flexibility exercise is usually performed by a therapist, but can also be performed by the patient himself. Cross your affected foot over your unaffected knee and gently grab your foot with your opposite hand behind the big toe joint. Hold your foot stationary throughout this exercise. Use your other hand to gently begin pulling your bit toe away from your foot as if you were trying to pull your toe directly out of its socket. Hold this pressure and begin to gently rotate your toe in a clockwise/counterclockwise motion. You Might Also Like Dorsiflexion Exercises The angle formed between the yellow and green line represents the hallux abductus angle or the deviation of the big toe (hallux) relative to the first metatarsal bones. If this angle is too large there are osteotomy procedures available (surgically breaking and re-aligning bone) to fix this angle as well. The next video demonstrates implant surgery for correction of a bunion. As just mentioned, this is generally done when your doctor determines that the cartilage is too worn out to be salvaged and is then replaced by an artificial joint. This procedure is sometimes performed in conjunction with an osteotomy procedure to realign the metatarsal and toe bones. A new device called the TightRope fixation manufactured by Arthrex is a high tension wire that is placed through the first and second metatarsal bones in an effort to reduce the distance between the two bones. The beauty of this concept is that an osteotomy does not have to be performed. Since most bunion complications generally center around the osteotomy itself, having another option to reduce the intermetatarsal angle is very exciting. This condition can be an acquired problem such as the example above or a congenital problem where there is a flare laterally of the fifth metatarsal bone resulting in the head of the bone being very prominent. The most common cause of hallux valgus is poorly fitting shoes, according to the American Academy of Orthopaedic Surgeons. Shoes with a tight toe box that push the toes together can lead to the formation of a bunion. High-heeled shoes are the worst for this condition. In fact, the American Academy of Orthopaedic Surgeons state that studies have shown that the majority of women in the U.S. wear shoes that are too small, and over half of them have bunions. Other factors like improper foot mechanics due to altered arch height play a role. Hallux valgus can also result from genetic factors and conditions like arthritis and neurological disorders. The symptoms can be varied, but normally theyinclude burning, numbness, pain, and a full feeling in the ball of the foot.These symptoms are often made worse with dress shoes. A bunion is inflammation of the soft tissues around the outer edge of the big toe at the joint where it is attached to the foot. The medical term for this type of inflammation is 'bursitis' and refers to the bursa or sac near the joint. Bunions are associated with various diseases of the joints including osteoarthritis and rheumatoid arthritis but usually there is no obvious underlying illness. What causes bunions and who is at risk?