Bunions in Children - Causes, Symptoms, and Treatment Options Explained

Understanding Bunions in Children

Bunions, also known as hallux valgus, are a common foot deformity that can develop in children. A bunion occurs when the big toe angles inward towards the second toe, causing a bump to form at the base of the big toe. While bunions tend to be associated with adults, they can occur in children too. Understanding the causes, symptoms, diagnosis, and treatments for bunions in children is important for parents seeking care for their child's foot pain or deformity.

What Causes Bunions in Children?

There are several potential causes and risk factors for bunions in children:

• Genetics - Bunions often run in families. Children with a parent or sibling with bunions are more likely to develop them.
• Foot structure - Children born with certain foot abnormalities like flat feet or excessive flexibility can be prone to bunions.
• Ill-fitting shoes - Wearing narrow, tight shoes that rub against the toes can put pressure on the big toe joint and cause bunions.
• Injury - Trauma or injury to the big toe joint, such as a fracture or ligament damage, may lead to a bunion later on.
• Connective tissue disorders - Conditions like Marfan syndrome and Ehlers-Danlos syndrome that affect connective tissues can increase bunion risk.
• Neuromuscular disorders - Diseases like cerebral palsy that affect muscle tone and coordination may increase the likelihood of bunions.

While bunions in adults often develop slowly over time, bunions in children are more likely to occur quickly. The bunion bump can form rapidly during growth spurts when bones are softer. Bunions typically stop progressing when bone growth stops after puberty.

Signs and Symptoms of Bunions in Children

Common signs and symptoms of bunions in children include:

• A visible bump on the side of the big toe joint
• Big toe turning inward toward the second toe
• Soreness, redness, or swelling around the big toe joint
• Corns or calluses under the big toe or second toe
• Stiffness, pain, or limited motion of the big toe
• Difficulty walking or discomfort with shoes due to bunion
• In severe cases, the second toe overlaps the big toe

Symptoms may occur with activity or when wearing closed-toe shoes and often improve with rest. Bunions can cause significant discomfort and affect daily activities, so prompt evaluation is recommended if a child develops signs of a bunion.

Getting a Bunion Diagnosis in Children

To diagnose a bunion in a child, a pediatrician, orthopedist, or podiatrist will perform a physical exam of the foot. They will look for hallmark signs like the bony bump, abnormal toe position, and limited joint mobility. Imaging tests may include:

• X-rays - To evaluate the angle of the big toe joint and look for arthritic changes or bone spurs.
• MRI or CT scan - If injury or other underlying condition is suspected.

The doctor will also assess factors that may be contributing, like the child's foot anatomy, joint laxity, neuromuscular disorders, and family history. Comparing the child's feet may reveal asymmetric bunion severity. Early evaluation and diagnosis sets the stage for prompt treatment to alleviate discomfort and prevent progression.

Nonsurgical Treatment Options for Bunions in Children

Most bunions in children can be managed conservatively through nonsurgical treatments focused on relieving symptoms. Options may include:

• Pain relief - Over-the-counter medications like acetaminophen or ibuprofen can temporarily alleviate discomfort associated with bunions.
• Bunion pads - Cushioned pads placed around the bunion can reduce friction and irritation inside shoes.
• Toe spacers - Devices worn between the first and second toes can help realign the big toe and take pressure off the joint.
• Custom orthotics - Inserts for shoes prescribed by a podiatrist can support the arch and improve foot alignment.
• Icing - Applying ice wrapped in a towel for 10-15 minutes can provide post-activity swelling relief.
• Child-specific footwear - Shoes with wide toe boxes, soft uppers, and adjustable closures can accommodate bunions.

Along with at-home care, physical therapy focused on stretching, strengthening foot muscles, and improving coordination may also help manage bunions. Preventing progression is key during childhood growth, so prompt conservative treatment provides lasting benefits.

When is Bunion Surgery Needed for Children?

If conservative treatments fail to adequately relieve pain and improve function, bunion surgery may be considered in severe or progressive cases. Reasons pediatric bunion surgery may become necessary include:

• Persistent, debilitating foot pain
• Problems fitting into shoes due to large bunion bump
• Delayed walking development
• Significant bunion deformity affecting gait
• Damaged joints causing limited mobility
• Failure of nonsurgical treatments to help

Surgery is generally delayed until adolescence when bone growth nears completion. The two main surgical approaches are:

• Osteotomy - Realigning and reconstructing bone to straighten the big toe joint.
• Arthrodesis - Fusing the jagged big toe joint completely to eliminate pain.

Following surgery, wearing a postoperative shoe and using crutches for several weeks facilitates healing. Physical therapy also helps strengthen the foot and improve function. For severe bunions causing disability, surgery can offer significant improvement.

Preventing Bunions in Children

Preventive measures can reduce a child's risk of developing bunions or minimize worsening. Strategies for bunion prevention include:

• Choosing properly fitted shoes with roomy toe boxes and cushioned soles
• Avoiding narrow, tight, or high-heeled shoes
• Selecting shoes with adjustable closures like Velcro instead of slip-on styles
• Wearing bunion splints or pads to protect painful areas
• Treating foot injuries promptly to prevent deformity
• Doing foot exercises to strengthen muscles and improve flexibility
• Using arch supports or orthotics as recommended

While hereditary factors play a key role, taking preventive footwear and lifestyle steps can help support foot health and potentially reduce bunion development in susceptible children.

The Takeaway on Bunions in Children

Although less common than in adults, bunions do occur in children due to genetic susceptibility, bone growth, and other factors. The characteristic bump at the base of the big toe can cause discomfort made worse by shoe pressure. Nonsurgical treatment focuses on relieving symptoms and preventing progression until later in adolescence when growth is complete. Surgery may be warranted in severe cases with debilitating pain or deformity. With prompt evaluation and proper conservative or surgical management, bunions can be treated effectively to restore foot function.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.