Bunions

Written by April Khan and Marijane Leonard | Published on July 25, 2012
Medically Reviewed by George Krucik, MD on July 25, 2012

Overview

A bunion is a problem with your big toe. On the outside, a bunion looks like a bump on the side of the toe. But this bump is actually the result of an abnormality of the foot bones. Your big toe leans toward your second toe instead of being straight. This angle produces the bump of the bunion. In some cases, the bump is painless. Over time, however, a bunion will cause the toes to crowd together, resulting in pain and the possibility of permanent deformity.

What Causes Bunions?

Bunions are generally thought to be genetic. They occur because of faulty foot structure, which is inherited. Some conditions that contribute to the development of bunions include flat feet, excessively flexible ligaments, and abnormal bone structure. Some experts believe shoes that do not fit properly cause bunions, but others think shoes only worsen an existing structure problem.

Bunions usually become worse over time. The following can aggravate bunions:

  • wearing shoes that are too small. Tight shoes cause your toes to crowd together and also put pressure on your big toe.
  • wearing high heels or other shoes with pointy toes. These styles force your toes together
  • staying on your feet for long periods of time
  • arthritis

What are the Symptoms of Bunions?

In addition to the bump, signs and symptoms of a bunion may include:

  • red and inflamed skin on the side of your big toe
  • your big toe turns toward your other toes
  • thick skin on the underside of your big toe
  • calluses on your second toe
  • foot pain that may be persistent or come and go
  • difficulty moving your big toe

The pain associated with a bunion might make it difficult to walk. See your physician if you experience:

  • persistent foot pain
  • inability to find suitable fitting shoes
  • decreased flexibility in your big toe
  • a large lump on or near the joint on your big toe

How Are Bunions Diagnosed?

In most cases, a physician can diagnose a bunion through visible inspection since many of the signs are outwardly present. During a physical exam, your doctor may ask you to move your toe back and forth to check for limited movement. If an injury or deformity is suspected, the doctor will order an X-ray for further examination. An X-ray can detail the severity of the bunion and pinpoint its cause. A blood test might also be necessary to rule out arthritis as a cause.

How Are Bunions Treated?

Bunions treatments include nonsurgical and surgical options.

Nonsurgical Options

  • Wearing shoes that contain padded soles and include adequate wiggle room for your toes.
  • Having your physician pad or tape your foot into a normal position, which works to reduce pressure on the bunion.
  • Taking over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen.
  • Wearing over-the-counter arch supports in your shoes.

Surgeries

If nonsurgical options do not provide sufficient help, surgery might be necessary. Many surgical procedures are used to treat bunions. Your doctor will recommend the best procedure for your situation. However, most surgeries to correct bunions include a bunionectomy.

A bunionectomy involves:

  • correcting the position of the big toe by removing some of the bone.
  • removing swollen tissue from the affected joint.

Full recovery from a bunionectomy can take up to eight weeks though, in most cases, you’ll be able to walk on your foot immediately following the procedure.

Complications From Bunions

An untreated bunion can cause irritation to the fluid filled sac used to cushion the joint, called the bursa. This causes the bursa to become inflamed and swollen, which causes pain and tenderness and may lead to limited movement of the joints nearby. This condition is called bursitis.

Additional complications of bunions include:

  • toe or foot deformity
  • stiff toe
  • chronic toe or foot pain

Contact your physician immediately if you experience these symptoms and also have diabetes or any signs of infection.

Preventing Bunions from Developing

Wearing shoes that fit properly is an effective way to prevent bunion development. A properly fitting shoe should have plenty of room around your toes and should conform to the shape of your foot.

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