What are bunions? 

A bunion is a bony bump that appears at the base of the big toe, extending out from the foot. The bump forms very slowly over time as a result of the anatomy of the foot changing. As the big toe moves inwards towards your small toes, the joint connecting your big toe to your foot starts to push outwards, forming the bunion. This condition is called hallux valgus.

Bunions can become painful if the shoes you wear do not fit properly or as the skin of the bunion rubs against the shoe. Bunions can result from the shape of your foot, wearing tight shoes, or another deformity. The condition of your foot may get worse over time, requiring corrective action to reduce pain and further foot disfigurement. There are many nonsurgical treatments that can address bunions.

What causes bunions?

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The direct cause of bunions is the condition called hallux valgus. Hallux valgus occurs when the big toe bone deviates from its position and laterally drifts towards the other toes and outside of the foot. As the smaller bones at the top of the big toe shift towards the outside of the foot, the long metatarsal starts to grow out to the inside of the foot. The visible bunion is actually the bone of the foot growing towards the inside of the foot. The bunion gets inflamed due to irritation from friction and the strain on the joints in their new position. 

While the exact cause of hallux valgus is unknown, there are some likely causes. Bunions may be caused by certain types of inflammatory arthritis that impact the joints of the foot. Other causes could relate to the body’s anatomy and inherited foot type that you are born with. Some experts think that tight-fitting, narrow shoes can be a factor in the initial deformity of the joint.

What are symptoms of bunions?

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You may experience visible or physical symptoms of bunions. The visible signs of a bunion include:

  • A protruding bump at the base of your big toe
  • Calluses or corns, resulting from the rubbing between the deformed big and little toes
  • Noticeable redness and swelling around the joint of the big toe 
  • Thicker skin on the sole of the foot by the big toe

In addition to the visible symptoms of a bunion, there are also physical symptoms associated with bunions. Common physical symptoms of bunions include:

  • Limited or restricted mobility of the big toe joint
  • Inflammation, pain, and tenderness centered around your big toe join
  • Persistent or recurring pain in the foot 
  • Difficulty walking or wearing confining shoes 
  • Numbness in the big toe

Symptoms can worsen while wearing the wrong shoes or putting too much pressure on the big toe joint. In addition, spending long periods of time on your feet can make symptoms more apparent. 

Are there any risk factors or groups for bunions?

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There are some risk factors that may make you more likely to develop bunions. Some risk factors relate to your health history while others relate to your lifestyle and shoe choices. Bunions are very common so having one of these risk factors does not guarantee you will develop a bunion. 

Poor Fitting Shoes: Wearing shoes that do not fit properly puts your foot at risk for a bunion or other deformity. When the foot is cramped within a tight shoe for extended periods of time, the joints slowly shift and form a bunion. Shoes like high heels do not allow the foot to be relaxed in the shoe.

Rheumatoid Arthritis: People with rheumatoid arthritis are predisposed to developing other joint conditions given the impact that arthritis has on the body. The arthritis in the toes can add to the joint inflammation that results from the bunion. 

Family History: Bunions could be an inherited problem, relating to your foot’s structure. Other foot issues like flat feet could contribute to your likelihood of bunions. 

How are bunions diagnosed? 

A doctor can typically diagnose a bunion by a physical examination in combination with imaging. During the appointment, your doctor will manipulate your foot to test the joint movement in your feet. In addition, they will look for inflammation or swelling and assess if the bunion is causing other issues. Your doctor will likely be able to confirm a bunion diagnosis with a simple review of your health history, symptoms, and foot. However, they may opt to x-ray the foot to determine the best treatment option for the foot. 

X-rays can help gauge the alignment of the foot and help detect arthritis in the joint. After the initial diagnosis appointment, you may need follow up appointments as the foot continues to shift. Your doctor may want to check on the foot over time to track the changes and update your treatment plan, as necessary.

How are bunions treated?

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No treatment for a bunion will make the bunion go away, but there are treatment options to help manage the pain and discomfort the bunion can cause. People often find relief with a variety of nonsurgical treatment options. However, there are some surgical options for more severe bunion complications. 

Nonsurgical Treatments:

  • Physical therapy: Foot exercises can help improve your foot’s alignment and reduce pain and inflammation in the soft tissue of your foot. Massages can also help relieve the stress on the bunion. 
  • Medication and icing: Over-the-counter pain medications like acetaminophen and ibuprofen can keep the pain and swelling of a bunion under control. Combining medications with icing helps reduce inflammation after periods of higher activity or strain on the foot. 
  • Bunion cushions and padding: Using padding on the bunion creates a buffer between the bunion and your shoe, which prevents friction and irritation. Padding and medical tapes can help stabilize the joint and ease the pain.
  • Orthotic inserts: Supportive shoe inserts ensure the pressure on the foot distributes evenly and does not fall solely on the bunion and keeps the foot in better alignment.
  • Changing shoes: Roomy shoes are the best kind of shoes for someone with a bunion. The space allows the foot to relax and the bunion to avoid irritating contact with the shoe. 
  • Injection therapy: Steroid injections are a temporary relief measure to relieve inflammation around the joint. Too frequent injections can be damaging, though, so your doctor may not recommend this treatment option. 

Surgical treatments:

Surgical treatment cannot remove the bunion in entirety. Instead, surgery aims to correct the joint or remove excess tissue to relieve pain. The procedures are all forms of a bunionectomy, which correct the shape of the foot. 

  • Remove excess swollen soft tissue from around the bunion
  • Removing parts of the bone to straighten the joint
  • Realigning bones to make the foot into a more correct position

Should you see a doctor for bunions?

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Bunions are typically not cause for concern and do not often need medical treatment. However, once you notice a bunion, you can schedule an appointment with a foot doctor to ensure no other complications arise from the bunion. Your doctor can suggest lifestyle adjustments and best practices to manage the pain of the bunion. 

You should monitor your symptoms and seek medical attention if you experience:

  • Uncomfortable and consistent big toe pain
  • Difficulty walking and inability to bear weight 
  • Severe inflammation in the joints 
  • Signs of infection and fever 

These symptoms can indicate a complication the bunion is causing that would necessitate more immediate medical attention.

What are the complications of bunions?

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Left untreated, bunions can cause complications that require medical attention. If you notice symptoms of any of these complications or signs of infection, you should contact your doctor immediately. 

Bursitis: Untreated bunions can create irritation of the fluid-filled sacs that cushion the toe joint. When the sacs, called bursa, become inflamed, they cause pain and tenderness in the joint. 

Hammertoe: Hammertoes occur when the toe bends in the middle of the joint. This bend causes pressure and pain to the toe and foot. 

Metatarsalgia: Bunions can cause pain in the ball of the foot, called metatarsalgia, which requires more specific treatment.

What is the outlook for people living with bunions?

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The outlook for people living with bunions is generally positive. Bunions do not go away, but the right treatment plan can help manage symptoms and maintain your quality of life. However, bunions that go without treatment will get worse over time. It is important to communicate with your doctor about the symptoms you experience to make sure the bunion does not become problematic. 

There are a variety of noninvasive treatments that can relieve the pain of the bunion and help keep your foot comfortable and supported. Simple changes like finding a good pair of shoes can make a big difference in your comfort level. Once a bunion starts to form, you cannot prevent the bunion from forming. However, you can take preventative measures like wearing good shoes with orthotic inserts to keep your foot aligned. Look for shoes with a wide toe box and space between the top of your big toe and the top of the shoe.