Key Points about Bunions

  • A bunion is a painful bony bump that develops on the outside of the big toe joint.
  • The cause of bunions is unknown. Factors that may contribute to the development include inherited foot shape, foot stress, inflammatory conditions such as rheumatoid arthritis, or wearing shoes that don't fit correctly.
  • Symptoms of bunions include a bump on the outside of the big toe, redness, swelling or tenderness in the affected area, reduced big toe movement and hardened skin on the bottom of the foot.
  • If you have a family history of bunions, you are more likely to develop bunions as you age.
  • If left untreated, a bunion can lead to a severe foot deformity.
  • Wearing properly fitting shoes is the primary way to prevent bunions from developing.
  • While many patients can be treated with nonsurgical therapies, some patients will need surgery.

Overview

Bunions, also known as hallux valgus, are bony bumps that grow on the inside of the foot at the joint where the foot meets the big toe. The exact cause is unknown but may be attributed to pressure on the big toe joint that presses the big toe toward the second toe. Gradually, the structure of the bone changes, causing a painful bump at the big toe joint.

While bunions are more common in women, anyone can develop one.

Wearing wider shoes with more toe room can help relieve pain as well as reduce pressure on the big toe. 

Bunion causes

The exact cause of bunions is not clear. Factors that may cause a bunion to develop include:

  • Wearing shoes that do not fit correctly. For example, shoes with a pointed toe box force your foot into an unnatural position.
  • Some people inherit feet issues from their parents due to the shape and structure of their feet.
  • Inflammatory conditions, such as rheumatoid arthritis.
  • Foot stress or injuries.

Bunion symptoms

The most common sign of a bunion is a bump that bulges outward on the outside of the big toe.

Other signs or symptoms of bunions include:

  • Redness or swelling on the big toe.
  • Corns or calluses between the first and second toe.
  • Persistent toe pain or pain that comes and goes.
  • Reduced movement in the big toe.
  • Hard skin on the bottom of the foot.

Bunion complications

While most patients with bunions do not have any bone deformity, patients who do not seek treatment may experience complications such as:

  • Arthritis in the big toe joint.
  • Deformities in the joint of the second toe.
  • Displacement of the second toe joint.

Bunion risk factors

Several factors may increase your risk of developing a bunion, including:

  • Having rheumatoid arthritis.
  • Inheriting a foot shape that is more prone to bunions.
  • Wearing shoes that do not fit correctly.
  • Wearing high heel shoes that put more pressure on the toes.

Bunion prevention

Bunions develop gradually over time, so it is essential to take care of your feet early in life to avoid developing bunions, especially if you have a family history of bunions.

Additional ways to prevent bunions include:

  • Exercise your feet.
  • Wear properly fitting shoes.
  • Avoid high heeled shoes or shoes with pointed toe boxes.

Bunion diagnosis

Your doctor can diagnose a bunion. During a clinic visit, your doctor will take a full medical history and perform an exam on your foot. In most cases, your doctor can diagnose a bunion with a review or your symptoms and the foot exam, but he or she will likely order an X-ray to confirm the diagnosis.

An X-ray will provide detailed images of the foot, which will allow your doctor to examine your toe alignment. The X-ray will also reveal how severe the bunion is so your doctor can determine the most effective method to treat it.

Bunion treatment

Your doctor will develop a treatment plan for your case. Although many people will be treated with conservative treatments, others may need surgery to relieve symptoms.

Nonsurgical treatments include:

  • Wear comfortable shoes that have a wide toe box.
  • Wear pads in your shoes that act as a cushion between your foot and your shoe.
  • Take medications such as acetaminophen or ibuprofen.
  • Ice your bunion if it becomes inflamed or swollen.
  • Wear shoe inserts that help distribute your body weight.

If nonsurgical treatments do not relieve your symptoms, surgery may be required. Surgery is recommended if you are having severe pain, and it is impacting your ability to perform your daily activities.


Surgical options include:

  • Remove tissue around the big toe joint.
  • Fusing the bones of the affected joint.
  • Correct the alignment of the bones to a normal position.
  • Remove part of the bone to straighten the big toe.

When to Seek Care

Bunions do not typically require medical treatment. If you have any of the following symptoms, call your doctor to schedule an appointment:

  • Persistent foot or big toe pain.
  • Bulging bump on the big toe.
  • Reduced movement of your big toe or foot.

Severe complications such as foot deformity can develop if a bunion is left untreated.

Next Steps

Your primary care doctor, orthopedist, or podiatrist can diagnose and treat bunions.

In preparation for your appointment, take notes on your symptoms, how long your symptoms have been present, and if you have a family history of bunions.

After being diagnosed and treated for bunions, carefully follow your doctor’s instructions. If treated with conservative therapies and your symptoms are not improving, contact your doctor to determine the next steps.

If you had surgery, it could take weeks or months to recover.

Wear proper-fitting shoes to prevent a recurrence.