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Bunions

A bunion is when your big toe points toward the second toe. This causes a bump to appear on the outside edge of your toe.

Alternative Names

Hallux valgus

Causes, incidence, and risk factors

Bunions are more common in women and can sometimes run in families. People born with abnormal bones in their feet are more likely to form a bunion.

Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion.

The condition may become painful as the bump gets worse, and extra bone and a fluid-filled sac grow at the base of the big toe.

Bunion
Bunion

Symptoms

  • Red, calloused skin along the inside edge of the big toe
  • A bony bump at this site
  • Pain over the joint, which pressure from shoes makes worse
  • Big toe turned toward the other toes

Signs and tests

A doctor can usually diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.

Treatment

When a bunion first begins to develop, take good care of your feet. 

  • Wear wide-toed shoes. This can often solve the problem and prevent you from needing more treatment.
  • Wear felt or foam pads on your foot to protect the bunion, or devices called spacers to separate the first and second toes. These are available at drugstores.
  • Try cutting a hole in a pair of old, comfortable shoes to wear around the house.

If the bunion gets worse and more painful, surgery to realign the toe and remove the bony bump (bunionectomy ) can be effective. There are more than 100 different surgical procedures to treat this condition.

Expectations (prognosis)

You can do well if you take care of the bunion when it first starts to develop, and wear different shoes. Teenagers may have more trouble treating a bunion than adults.

Surgery reduces the pain in many, but not all, people with bunions. After surgery, people often have trouble wearing tight, fashionable shoes.

Calling your health care provider

Call for an appointment with your doctor if the bunion:

  • Continues to cause pain even after self care, such as wearing wide-toed shoes
  • Prevents you from doing your usual activities
  • Has any signs of infection (like redness or swelling), especially if you have diabetes

Prevention

Avoid compressing the toes of your foot with narrow, poor-fitting shoes.

References

Wexler D, Grosser DM, Kile TA. Bunion and bunionette. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 76.

Richardson EG. Disorders of the hallux. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 78.

Updated: 2/27/2012

Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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