Bunions aren’t just something old people develop. This deformity can be triggered by a number of causes and therefore can affect people at different ages.
Often, a bunion develops due to stress on the metatarsophalangeal (MTP) joint in your big toe. This joint is located where the first long foot bone (metatarsal) meets the first toe bone (phalanx). As you take a step, the joint bends, which allows you to push off the foot and move the other leg forward. That means, for a brief moment, the MTP joint has to fully support half your body weight. The joint is strong, but the more active you are and the more you stress it, the more likely it is to develop problems like bunions.
At Monroe Foot & Ankle Care, podiatrist and podiatric surgeon Dr. Elliott Perel sees many patients who’ve developed bunions, not just from stress, but also from other causes, such as rheumatoid arthritis (RA). Here’s what you should know about the RA-bunion link.
The most common way bunions develop
Bunions don’t develop overnight. They form over many years, which is why older people often have them.
The process usually starts when the toes are routinely pressed together. This can happen if you often wear shoes with a narrow toe box or high heels that move your weight to the front of your foot. The pressure weakens the ligaments responsible for holding the toe straight. As a result, the MTP joint moves outward, and the big toe shifts inward toward the second toe.
As the bones move out of alignment, a bulge forms at the MTP joint. This is a bunion. And as the bunion grows, it rubs against the side of your shoes, becoming red, swollen, and painful. It may become difficult to find shoes that fit, and in advanced cases, it may even be hard to walk.
Smaller bunions, known as “tailor’s bunions,” can also form at the base joint of your little toe.
How rheumatoid arthritis breeds bunions
RA is an autoimmune disease. This means the immune system mistakenly attacks one’s own tissues, damaging and destroying them in the process.
RA is also a type of arthritis, a term that derives from the Greek, meaning “joint inflammation.” In the case of RA, the body attacks the joint tissues, causing widespread inflammation.
How does this work? The body’s joints are covered with a lining — called synovium — that lubricates the joint, making it easier to move. RA causes the synovium to swell. This eventually destroys the joint and the ligaments, bones, and other tissues that support it.
Aside from this, weak ligaments can lead to joint deformities — such as claw toe or hammertoe. And a softening of the bone (osteopenia) from RA can result in stress fractures and bone collapse. When these are added to the normal stress on the MTP joint, it’s easy to see how and why the joint moves out of alignment, forming bunions.
Keep in mind, over 90% of people with RA develop symptoms in the foot and ankle at some point. In about 20%, foot and ankle symptoms are the first signs of the disease.
If you’ve developed bunions, or if you have rheumatoid arthritis and want to learn how to prevent bunions, come into Monroe Foot & Ankle Care for a consultation with Dr. Perel. Give our office a call at 732-978-9569 or book online with us today.