What Is a Bunion?

A bunion is an unnatural, bony hump

that forms at the base of the big toe
where it attaches to the foot. Often, the
big toe deviates toward the other toes.
When this occurs, the base of the big
toe pushes outward on the first
metatarsal bone -- which is the bone
directly behind the big toe -- forming a
bunion. If this happens on the little toe
and fifth metatarsal, it's called a
bunionette.
Because a bunion occurs at a joint,
where the toe bends in normal walking, your entire body weight rests on the bunion at
each step. Bunions can be extremely painful. They're also vulnerable to excess
pressure and friction from shoes and can lead to the development of calluses.

Causes
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Bunion

Bunions develop when the pressures of bearing and shifting your weight fall unevenly
on the joints and tendons in your feet. This imbalance in pressure makes your big toe

joint unstable, eventually molding the parts of the joint into a hard knob that juts out
beyond the normal shape of your foot.
Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or
whether footwear simply contributes to bunion development. Other causes include:

Inherited foot type

Foot injuries

Deformities present at birth (congenital)

Bunions may be associated with certain types of arthritis, particularly inflammatory

types, such as rheumatoid arthritis. An occupation that puts extra stress on your feet or
one that requires you to wear pointed shoes also can be a cause.

Symptoms
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The signs and symptoms of a bunion include:

A bulging bump on the outside of the base of your big toe

Swelling, redness or soreness around your big toe joint

Thickening of the skin at the base of your big toe

Corns or calluses these often develop where the first and second toes overlap

Persistent or intermittent pain

Restricted movement of your big toe

When to see a doctor

Although bunions often require no medical treatment, see your doctor or a doctor who
specializes in treating foot disorders (podiatrist or orthopedic foot specialist) if you have:

Persistent big toe or foot pain

A visible bump on your big toe joint

Decreased movement of your big toe or foot

Difficulty finding shoes that fit properly because of a bunion

Risk factors
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These factors may increase your risk of bunions:

High heels. Wearing high heels forces your toes into the front of your shoes, often
crowding your toes.

Ill-fitting shoes. People who wear shoes that are too tight, too narrow or too pointed are
more susceptible to bunions.

Arthritis. Pain from arthritis may change the way you walk, making you more susceptible
to bunions.

Heredity. The tendency to develop bunions may be present because of an inherited

structural foot defect.

Complications
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Although they don't always cause problems, bunions are permanent unless surgically
corrected. Possible complications include:

Bursitis. This painful condition occurs when the small fluid-filled pads (bursae) that
cushion bones, tendons and muscles near your joints become inflamed.

Hammertoe. An abnormal bend that occurs in the middle joint of a toe, usually the toe
next to your big toe, can cause pain and pressure.

Metatarsalgia. This condition causes pain and inflammation in the ball of your foot.

Preparing for your appointment

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If you're having problems with your feet, you're likely to start by seeing your primary care
doctor. Your primary care doctor may refer you to a foot specialist (podiatrist or
orthopedic foot specialist).

What you can do

To make the most of your time with your doctor, prepare a list of questions before your
visit. Your questions might include:

What's causing my foot problems?

Is this condition likely to be temporary or permanent?

What treatment approach do you recommend?

Am I a candidate for surgery? Why or why not?

Are there any additional self-care steps that might help?

Don't hesitate to ask any other questions.

What to expect from your doctor

Some questions your doctor might ask of you include:

When did you begin having foot problems?

How much pain do you have in your foot?

Where is the pain?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

What type of shoes do you wear?

Tests and diagnosis

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Your doctor can identify a bunion by examining your foot. Watching your big toe as you
move it up and down will help your doctor determine if your range of motion is limited.
Your doctor will also look for redness or swelling.
After the physical exam, an X-ray of your foot can help your doctor identify the cause of
the bunion and rate its severity.

Treatments and drugs

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Treatment options vary depending on the severity of your bunion and the amount of pain
it causes.

Conservative treatment
Nonsurgical treatments that may relieve the pain and pressure of a bunion include:

Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your
toes.

Padding and taping or splinting. Your doctor can help you tape and pad your foot in a
normal position. This can reduce stress on the bunion and alleviate your pain.

Medications. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or

naproxen (Aleve) can help you control the pain of a bunion. Cortisone injections also can be
helpful.

Shoe inserts. Padded shoe inserts can help distribute pressure evenly when you move
your feet, reducing your symptoms and preventing your bunion from getting worse. Over-thecounter arch supports can provide relief for some people, although others may require
prescription orthotic devices.

Applying ice. Icing your bunion after you've been on your feet too long can help relieve
soreness and inflammation.

Surgical options
If conservative treatment doesn't provide relief from your symptoms, you may need
surgery. The goal of bunion surgery is to relieve discomfort by returning your toe to the
correct position.
There are a number of surgical procedures for bunions, and no one technique is best for
every problem.
Surgical procedures for bunions might involve:

Removing the swollen tissue from around your big toe joint

Straightening your big toe by removing part of the bone

Realigning the long bone between the back part of your foot and your big toe, to
straighten out the abnormal angle in your big toe joint
Joining the bones of your afected joint permanently

It's possible you may be able to walk on your foot immediately after a bunion procedure.
However, full recovery can take weeks to months. To prevent a recurrence, you'll need to
wear proper shoes after recovery. It's unlikely that you'll be able to wear narrower shoes
after surgery.
Surgery isn't recommended unless a bunion causes you frequent pain or interferes with
your daily activities. Talk to your doctor about what you can expect after bunion surgery.

Lifestyle and home remedies

By Mayo Clinic Staf

These tips may provide relief from a bunion:

Apply a nonmedicated bunion pad to the bony bump.

Apply an ice pack two to three times daily to help reduce swelling if a bunion becomes
inflamed or painful.

Wear shoes with a wide, deep toe box.

Avoid shoes with heels higher than 2 1/4 inches (5.7 centimeters).

See your doctor if pain persists.

Prevention
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To help prevent bunions:

Be sure your shoes don't cramp or irritate your toes.

Choose shoes with a wide toe box there should be space between the tip of your
longest toe and the end of the shoe.

Your shoes should conform to the shape of your feet without squeezing or pressing any
part of your foot.

Avoid pointy-toed shoes.