Overview

What is a bunion?

It is a bony lump that grows at the metatarsophalangeal (MTP) joint of your first toe, where it meets with the foot. It grows slowly over the years, then becomes larger and bulge. It will push your big toe in so it rubs against the toe next to it (that's right), so much so that the big toe may overlap it. The medical term for bunion is hallux valgus.

If you have a lump on your big toe and are feeling pain, stiffness, or numbness in your toes or feet, consult your doctor.

What are the types of bunions?

The most common type is a bunion caused by extra pressure from another toe pressing into this one, but there are other reasons why bunions can occur, too. There are other types, including:

Congenital hallux valgus also referred to as congenital bunions: The child is born with a bunion.
Juvenile or adolescent hallux valgus: This kind of bunion occurs among young people under 18 years of age.
Tailor's bunion (bunionettes): A tailor's bunion occurs at the base of your little (pinky) toe. They commonly develop because of an incorrect shoe fitting or because of doing some activity that causes you to press your little toe inward toward your other toes.

What are the symptoms of a bunion?

The most obvious symptom of a bunion is the lump that develops at the base of your big toe. You can often see and feel the bony lump. Sometimes, a bunion will cause other symptoms. These include:

Pain and stiffness in your big toe.
Swelling.
Discoloration or redness
You cannot move or bend your big toe; you may even feel pain or a burning feeling whenever you bend your toe.
Pain or discomfort when walking in certain shoes.
Corns or calluses.
Hammertoes, painful flexed tendons, and joints in the toes
Numbness, aching, burning, or an electric shock-like feeling in or around your big toe.

What causes bunion?

There is no single cause for bunions. Researchers think that perhaps a family history, abnormal bone structure, increased motion, and the type of shoes you wear may cause this condition. When sustained external forces or pressures are exerted on the joints of the big toe for prolonged hours and over a long duration (usually years), most of the forces can force the big toe to be misaligned with the rest of the toes. Eventually, bunion formation can occur on the metatarsophalangeal (MTP) joint due to adaptive mechanisms towards the displacement of the toe.

The following factors commonly cause increased pressure on the big toe joint:

When the toe box is too narrow or pointed, it might be too tight for your toes. In that case, this is referred to as toe box problems. This design encourages the toes to be stuffed in front, resulting in an overlap of the toes.
The way you walk (your gait mechanics).
Certain medical conditions cause inflamed pain, such as rheumatoid arthritis or lupus.
Standing or working long hours.

What are the risk factors?

A bunion can strike anybody. Those at a greater risk of bunions are in the following categories:

Those assigned female at birth (AFAB).
Individuals whose biological parents suffered from bunions or malformations of the foot's mechanics. Over 70% of individuals who suffer from bunions have a parent who has them.
People who have experienced previous foot injuries, which may include athletes.

What are the complications of Bunions?

Having a bunion may increase your complications of:

Bursitis (painful, fluid-filled sacs around joints).
Hammertoes.
Osteoarthritis.

How are bunions diagnosed?

A doctor will conduct a physical check-up to identify a bunion. They will check your foot and ask questions about the pain. Let your doctor know if certain things worsen your symptoms or how long you have noticed a lump near your big toe.

You might need to see a podiatrist, a doctor who has received special training in treating feet.

What tests are performed to diagnose bunions?

You may not need any tests for your doctor to diagnose a bunion. The X-ray imaging of your foot will tell whether your bones and the MTP joint are perfectly aligned.

How are bunions treated?

The most common bunion treatments include:

Footwear changes: You can wear wide shoes with deep-toe boxes to help relieve pressure from your toes. You can even stretch shoes you already own to make them wider using a stretching device.
Bunion pads and taping: OTC bunion pads provide cushioning around a bunion, decreasing pressure on the area. Your provider may advise using medical tape to maintain proper toe alignment.
Orthotics: These are shoe inserts that support your feet. You might consider either an over-the-counter kind or a custom fit. Your doctor may advise spacers between the big toe and the second toe. Your provider may also recommend a splint to keep your big toe straight when you are not wearing shoes.
Pain relievers: NSAIDs have been found to reduce pain and swelling. You may need oral tablets or topical NSAIDs applied to your skin over a bunion. Do not take NSAIDs for more than ten consecutive days without consulting your provider.
Applying ice or a cold pack to your affected toe may also help. Put a thin towel over a cold pack so it does not touch your skin directly.
Corticosteroids: Corticosteroids are prescription drugs. They reduce inflammation.
Physical therapy: You may need to visit a physical therapist to help you maintain an ideal foot strengthening activity. They can provide you with exercises or stretches that can keep your toes in proper alignment.
Surgery: Your doctor may recommend bunion correction surgery if other therapies do not help you find relief from your symptoms or if walking becomes painful. Your doctor or surgeon can tell you what kind of surgery you might need and what to expect.

Can I prevent a bunion?

Since bunions are formed from the confluence of several different factors, prevention is not easy. However, properly fitting shoes can at least slow the appearance of bunions. In general, as a tip to help you find the right fitting shoe for your comfortable fit, do this:

Avoid wearing tight shoes with narrow, pointed tips — especially those that hurt or fit too tightly onto your toes.
Even if you know your size, try on a few different kinds of shoes to ensure the best fit. Labeled shoe sizes are not always the same between brands and styles.
Before buying a new pair of shoes, sit, stand, and walk in them and check if movements and support in any of these positions cause you pain, pinching, or pushing of your toes.
Trying shoes on end may give a more accurate fit because the feet would naturally swell a bit over the course of a day and are larger later in the day than first thing in the morning.

Your provider or podiatrist may be able to recommend types or brands of shoes that might work better for your feet. If you have other conditions of your foot's structure, like flat feet or high arch feet, ask your provider if you'll need orthotics to prevent a bunion.

What do I expect if I have bunions?

Most people with bunions are able to manage their symptoms with few long-term effects on their way of life. Your doctor and the other members of your medical team will work with you to identify possible treatments that can alleviate symptoms, eliminate discomfort, and maintain the health and strength of your feet and toes.

Don't wait until you see your provider if you have symptoms of a bunion. The earlier you start treatment, the better your chance is that you can manage your symptoms without surgery.

As a general rule, patients with a bunion who need surgery can return to all their normal activities within two to three months.