A bunion is a bony bump that forms at the base of your big toe. It forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. The skin over the bunion might be red and sore.
Smaller bunions (bunionettes) may appear on the joint of your little toe.
You may experience visual symptoms, including a “bump” on the toe joint. It may also be difficult to move your big toe, and pain may persist as a result of bunions. Other problems, such as wearing proper-fitting shoes, can potentially be an issue as well. A burning sensation or redness may also accompany the visible evidence of the bunion.
Why do bunions happen?
Bunions may occur on your toe as a result of inherited structural conditions, or they may be a result of external stresses such as wearing poorly-fitted or tight shoes. They may also happen because of wear and tear or excessive weight burdens associated with arthritis.
How are bunions treated?
Your foot and ankle doctor will conduct a visual examination and may order an X-ray to evaluate your bunion. In the early stages of bunion care, your physician may advise you to wear special orthotic padding in your shoes to alleviate discomfort. Anti-inflammatory medication and periodic icing may also relieve pain. Generally, non-surgical treatment and behavioral modification are preferable and will be prescribed first.
For more problematic cases, when non-surgical/conservative methods do not work or are not appropriate, surgery may be necessary to correct the problem. Bunion surgery will help not only remove the “bump” but also correct any underlying structural problems that may have caused the condition. After surgery, your physician will put you in a post-operative shoe and will conduct follow-up visits with you to evaluate the progress of your recovery. Dress shoes are not advisable for 5-6 months after surgery, and behavior must be modified to minimize swelling. As your foot continues to heal, modifications will be changed or reduced to enable you to slowly ease back into normal footwear and activity.
Bunions in Adults
*Adolescents listed at the bottom
Do you feel or have any of these symptoms?
Bony bump causing pain and tenderness when walking or putting on shoes
Enlargement of the base of the big toe
Redness and inflammation on the inside of the foot
Hardened skin on the bottom of the foot
A callus or corn on the bump
Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
Before you see a physician
Potential at-home treatments
It is important to note that these cannot “reverse” the bunion. However, it will prevent it from worsening and reduce pain
Changing footwear
In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe. You want to avoid forcing your foot into tight shoes that do not fit and crowd the toes.
*See more tips for changing footwear in Proper Shoe Fit and Prevention
Icing
Applying ice several times a day for 20 minutes at a time can help reduce swelling. Do not apply ice directly on your skin.
Medications
Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help relieve pain and reduce swelling. Other medications can be prescribed to help pain and swelling in patients whose bunions are caused by arthritis.
Reasons to see a physician and treatment options
If your bunion has progressed to the point where you have difficulty walking or experience pain despite changing shoes, you may be a candidate for surgery.
An advanced bunion can greatly alter the appearance of the foot. In severe bunions, the big toe may angle all the way under or over the second toe. Pressure from the big toe may force the second toe out of alignment, causing it to come in contact with the third toe. Calluses may develop where the toes rub against each other, causing additional discomfort and difficulty walking.
Bunion surgery realigns bone, ligaments, tendons, and nerves so your big toe can be brought back to its correct position. There are several different techniques that can be performed to ease your pain; see a foot and ankle orthopedic surgeon to discuss your options.
Proper shoe fit and Prevention
Bunions start out small- but can get worse overtime (especially if the individual continues to wear tight, narrow shoes)
Prevention is critical if you see a bunion developing. To minimize your chances of a bunion worsening or developing.
Do not select shoes by the size marked inside the shoe. Sizes vary among shoe brands and styles. Judge the shoe by how it fits on your foot
Never force your foot into tight shoes that don’t fit or that crowd your toes
Choose shoes that conform to the shape of your feet
Typically look for ones with wide insteps, broad toe boxes, and soft soles.
In general, you will want to avoid shoes that are short, tight, or sharply pointed, and those with heels higher than 2 1/4 inches.
Have your feet measured. The size of your feet can change as you grow older.
Walk in the shoe to make sure it fits and feels right and there is no slippage or discomfort.
Remember fashionable shoes can be comfortable.
If you already have a bunion, wear shoes that are roomy enough to avoid putting pressure on the big toe. This should relieve most of your pain. You may want to have your shoes stretched out professionally. You also may use protective pads to cushion the painful area, or a spacer to maintain the gap between the big toe and the second toe.
Adolescent Bunion
In addition to the common bunion, there are other types of bunions. As the name implies, bunions that occur in young people are called adolescent bunions. These bunions are most common in girls between the ages of 10 and 15.
While a bunion on an adult often restricts motion in the MTP joint, a young person with a bunion can normally move the big toe up and down. An adolescent bunion may still be painful, however, and make it difficult to wear shoes.
As opposed to adult bunions — which usually are associated with long-term wear of narrow, tight shoes — adolescent bunions are often genetic and run in families.
Bunionette
A bunionette, or “tailor’s bunion,” occurs on the outside of the foot near the base of the little toe. Although it is in a different spot on the foot, a bunionette is very much like a bunion. You may develop painful bursitis and a hard corn or callus over the bump.
Anatomy
Bones and joints in the foot
The big toe is made up of two joints. The largest of the two is the metatarsophalangeal joint (MTP), where the first long bone of the foot (metatarsal) meets the first bone of the toe (phalanx).
