What is a bunion?

A bunion is a bony bump that forms at the base of the big toe where it attaches to the foot. It develops when your big toe pushes against the others, forcing the joint to get bigger and stick out. The skin over the bunion might be red and sore. Smaller bunions (called bunionettes) can develop on the joint of your little toe. If left untreated, bunions often become bigger and more painful over time. 

How do bunions occur?

Bunions form when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance makes your big toe joint unstable, eventually causing a hard knob that juts out beyond the normal shape of the foot. Wearing tight, narrow shoes might cause bunions or make them worse. Bunions can also develop as a result of an inherited structural foot defect, congenital disorder (present at birth) or a medical condition, such as osteoarthritis or rheumatoid arthritis.

What are the symptoms?

Symptoms of a bunion include:

  • A bulging bump on the outside of the base of your big toe
  • Swelling, soreness or redness around your big toe joint
  • Corns or calluses
  • Persistent or intermittent pain
  • Restricted movement in your big toe

In many cases, symptoms are mild. But if your pain persists or worsens, it's important to consult a foot specialist to ensure proper evaluation and treatment.

How are bunions diagnosed?

In addition to a physical exam and health history, your doctor may take an X-ray of your foot to identify the cause of the bunion and rate its severity.

What is the treatment?

Treatment varies depending on the severity of your bunion and the amount of pain it causes. Nonsurgical treatments that may relieve pain and pressure include:

  • Wearing roomy, comfortable shoes that do not compress the toes
  • Orthotics or shoe inserts
  • Padding or splinting the foot to reduce stress on the bunion
  • Over-the-counter medications such as acetaminophen or ibuprofen
  • Cortisone injections

If these conservative measures fail to alleviate your symptoms and you have pain that interferes with daily activities, surgery may be necessary. The goal of surgery is to relieve discomfort by returning your big toe to the correct position. Your surgeon can often realign the bone behind the toe by cutting the ligaments at the joint. For a severe bunion, the bone may be cut in a technique called an osteotomy. Wires or screws may be inserted to keep the bones in place, and excess bone may be shaved or removed.

Most patients are able to walk immediately after bunion repair. However, full recovery can take weeks or even months. Patients are encouraged to wear roomy, well-fitting shoes after bunion surgery and avoid narrow footwear to prevent a recurrence.