What is a bunion?
A bunion is often described as a protruding "bump" on the side of the big toe. The visible bump looks like a growth, but it actually reflects changes in the bony framework of the long bone behind the big toe, called the metatarsal bone. As the bones shift, the big toe leans towards the second toe and a bump emerges.
In some cases, the shifting position of the big toe causes the second toe to lift up, eventually overlapping with the big toe. This is called a hammertoe.
Bunions are often hereditary, meaning that they run in families. There are also certain medical conditions that can cause bunions, such as rheumatoid arthritis. Shoes that squeeze the toes can cause them or make them worse. Women suffer from bunions more than men, probably because women's shoes tend to cramp the toes.
An inflamed bunion can be quite painful, and even the roomiest shoes can be uncomfortable. Most bunions develop slowly, and without any treatment, they will get worse with time.
What are the symptoms of bunions?
The most obvious sign of a bunion is a bump on the outside of the big toe joint. It may appear swollen and red. Bunions can be inflamed and painful to the touch, when you stand or walk, and especially when you put on shoes.
If you have bunions, we recommend seeing one of our doctors before they cause you pain.
Can bunions be prevented?
Some people are more prone to bunions than others, but choosing shoes carefully can prevent them or prevent them from getting worse. Tight, pointy shoes squeeze the toes together, which can eventually lead to a change in your foot's structure that causes bunions. High heels add pressure to the toes and make your foot even more prone to a deformity.
Choose shoes with a wide toe box and make sure that there is about a half an inch of space between your longest toe and the tip of the shoe. This will also help prevent hammertoes.
How are bunions diagnosed?
A weight-bearing X-ray of your foot will diagnose bunions. Physicians measure the angle between the first and second metatarsal bone. An angle greater than ten degrees indicates that the bone behind the big toe has moved and caused a bunion.
Bunions are sometimes confused with arthritis of the big toe joint, which also causes a painful bump on the big toe. This is also called hallux rigidus. An X-ray will tell us what is causing your pain and help guide treatment.
How are bunions treated?
The treatment we recommend will depend on the severity of your bunion and the level of pain you are experiencing. At an early stage, we can treat bunions with a variety of non-invasive treatments. Conservative treatments for bunions include:
- roomier shoes which allow the toes to spread out to their natural position.
- padding around the bunion which can relieve the pain caused by wearing shoes.
- anti-inflammatories, such as ibuprofin, which reduce inflammation and pain.
- orthotics, or custom shoe inserts, which redistribute the pressure on your joints and can help prevent bunions from getting worse.
- steroid injections, which provide longer term relief from inflammation caused by bunions.
When conservative treatments no longer prevent your bunion from affecting your daily activity—or if you are experiencing regular pain when previously you weren't—bunion surgery may be the next step. A consultation with our foot surgeons can help you decide whether bunion surgery is right for you.
Complications from bunions
Left untreated, bunions change the alignment of other toes, which can lead to discomfort. They can also cause painful skin irritations. Complications from bunions include:
- hammertoes
- bursitis
- arthritis
- metatarsalgia (pain on the bottom of the foot)
- painful skin lesions such as calluses and corns
The goal of bunion treatment is to relieve pain, keep you active, and prevent complications.
