Bunions

A bunion looks like a bump on the side of the big toe. This bump is actually the result of an abnormality of the foot bones that causes your big toe to lean toward your second toe instead of being straight. This angle produces the bump you see on your toe.

In some cases, the bump is painless. Over time, however, a bunion will cause the toes to crowd together. This can cause pain, and possibly a permanent deformity.

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 don’t fit properly cause bunions, but others think shoes only worsen an existing structural problem.

Bunions usually become worse over time. They can be aggravated by:

• tight or too-small shoes that cause your toes to crowd together and put pressure on your big toe
• shoes that have high heels or pointy toes — these styles force your toes together
• standing for long periods of time
• arthritis symptoms in your feet

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 turning 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 doctor if you experience:

• persistent foot pain
• inability to find shoes that fit you comfortably
• decreased flexibility in your big toe
• a large lump on or near the joint on your big toe

In most cases, a doctor 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. Your doctor will order an X-ray if they suspect an injury or deformity. 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.

There are surgical and nonsurgical treatment options for your bunion.

Nonsurgical options

Nonsurgical options include:

• wearing shoes that have padded soles and provide adequate wiggle room for your toes
• having your physician pad or tape your foot into a normal position, which reduces 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

Surgery might be necessary if nonsurgical options don’t help you. 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. In most cases, you’ll be able to walk on your foot immediately following the procedure.

An untreated bunion can cause irritation to the fluid-filled sac that cushions 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 other joints in the toe. This condition is called bursitis.

Other possible complications of bunions include:

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

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

There are many surgical and nonsurgical treatments available for bunions. Contact your doctor if a bunion is making it difficult to walk or put your shoes on.

Wearing shoes that fit properly is an effective way to stop bunions from forming. A properly fitting shoe should have plenty of room around your toes and should conform to the shape of your foot.