Yes, you read the headline correctly: children can (and do) get bunions, just like adults.
And just like with bunions in adults, early detection and treatment of a juvenile bunion can save your child a lot of discomfort and trouble in the future. Unfortunately, it can be easy to overlook bunion symptoms in a child, simply because the problem may not be expected to happen at a young age!
Let’s start with what to look for.
Symptoms of Juvenile Bunions
A juvenile bunion will likely not look as progressively bumpy and stuck out as what you might expect from a bunion in an adult. That is simply due to the fact that time is what causes that progression.
But there is still definitely a problem! What we need to be concerned about early on is the fundamental instability that causes the metatarsophalangeal (MTP) joint at the base of the big toe to start shifting in the first place.
Symptoms of a juvenile bunion can include:
- Irritation around the joint of the big toe
- Starting to see a tilting of the big toe toward the second toe
- Your child wanting to end playing early, or not want to go on long walks (due to discomfort)
- Complementary foot abnormalities, such as flat feet or overpronation
In the majority of cases, bunions will be present on both feet. Having a bunion on just one foot is not impossible, but uncommon.
If you ever suspect that your child might have juvenile bunions, please do not wait to see if the condition becomes worse before deciding to have them evaluated. Bunions never improve on their own, and it is much, much easier to manage a bunion in its earlier stages than to try and manage one later on. Even if it turns out there is no bunion in need of treatment, the peace of mind is worth it.
How Does a Child Get a Bunion?
Juvenile bunions are largely a hereditary condition. About 90% of cases have a strong family link. That means a history of bunions in your family is a good reason to keep a closer eye on your child’s feet.
There are two general classifications of juvenile bunions:
- A bunion prominently detected at birth.
- A bunion that is not as aggressive, and tends to be discovered closer to adolescence.
In the first case, it is believed that the position of the developing child against the uterus might have a role in creating the instability. In the second case, an abnormality in biomechanics (such as flat feet) can place pressure on the joint over the long term.
External factors, such as what shoes are worn, do not create the problem. Nobody ever really “makes their own” bunion. Although certain behaviors can make an existing case worse, the base deformity was already there to begin with.
Other conditions can also cause significant complications to a bunion. Metatarsus adductus, a condition in which the bones of the toes (metatarsals) are all shifted to make the forefoot curve inward, must be identified and treated early to prevent additional trouble.
Treating Juvenile Bunions
A bunion can’t be reversed – at least not without surgical intervention. When a bunion is in its early stages like this, our main goals will be to slow the bunion’s progression and manage any symptoms that may be present. Ideally, this will make the bunion be barely any problem for the child throughout their life.
How do we do this? One goal may be to control any biomechanical issues that might be contributing to the base instability. An abnormality in foot structure or gait is often a contributing factor. If we manage that, we can take a lot of excess stress off the unstable joint.
The fact that your child’s feet are still developing and growing can serve as both an advantage and a disadvantage at this time.
The growth plate (where new bone grows) is at the base of the toe. If growth occurs in an unfavorable direction, it can worsen the problem. However, we are also more capable of manipulating the growth at this time to achieve a better, more stable structure.
A minor surgical procedure called epiphysiodesis can gently alter this growth by manipulating the bone. It is a bit like pruning a tree for optimal growth.
Other potential routes of treatment and management exist, all dependent upon the specific situation and the needs of each young patient. Dr. Leibovitz will naturally discuss all options with you, and happily answer any questions regarding his recommendations.
Keep Juvenile Bunions from Growing Up
The sooner you take action to treat and manage juvenile bunions, the better. Early biomechanical control can lessen the deformity, while early treatment keeps the problem isolated and less likely to spin off additional problems such as crossed toes and chronic pain. It’s effectively stopping the first domino in a line.