Bunions

Topic Overview

What is a bunion?

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe. The big toe may turn toward the second toe. The tissues around the joint may be swollen and tender.

A bony bump at the base of the little toe is called a bunionette or tailor's bunion. The little toe also bends inward, and the joint swells or enlarges.

What causes a bunion?

You may get bunions if:

• The way your foot is shaped puts too much pressure on your big toe joint. Because bunions can run in families, some experts believe that the inherited shape of the foot makes some people more likely to get them.
• Your foot rolls inward too much when you walk. A moderate amount of inward roll, or pronation, is normal. But damage and injury can happen with too much pronation.
• You have flat feet.
• You often wear shoes that are too tight.

All of these may put pressure on the big toe joint. Over time, the constant pressure forces the big toe out of alignment, bending it toward the other toes.

What are the symptoms?

Your bunion may not cause any symptoms. Or you may have pain in your big toe, red or irritated skin over the bunion, and swelling at the base of the big toe. The big toe may point toward the other toes and cause problems in other toes, such as hammer toe. A bunionette can cause similar symptoms at the base of the little toe.

How are bunions diagnosed?

Your doctor will ask questions about your past health and carefully examine your toe and joint. Some of the questions might be: When did the bunions start? What activities or shoes make your bunions worse? Do any other joints hurt? The doctor will examine your toe and joint and check their range of motion. This is done while you are sitting and while you are standing so that the doctor can see the toe and joint at rest and while bearing weight.

X-rays are often used to check for bone problems or to rule out other causes of pain and swelling. Other tests, such as blood tests or arthrocentesis (removal of fluid from a joint for testing), are sometimes done to check for other problems that can cause joint pain and swelling. These problems might include gout, rheumatoid arthritis, or joint infection.

How are they treated?

Currently, no strong evidence points to the best treatment for bunions. But in most cases, you can treat them at home. This includes taking medicine you can buy without a prescription to relieve toe pain. It also helps to wear shoes that do not hurt your feet. For example, avoid high heels or narrow shoes. You can wear pads to cushion the bunion, and in some cases, you can use custom-made shoe inserts (orthotics).

Avoid activities that put pressure on your big toe and foot. But don't give up exercise because of toe pain. Try activities that don't put a lot of pressure on your foot, such as swimming or bicycling.

Surgery to correct a bunion may be an option if other treatment does not relieve pain. There are different types of surgery for bunions. You and your doctor can decide which one is best for you.

How can you prevent bunions?

Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint.

Medicine will not prevent or cure bunions.

Frequently Asked Questions