What Is a Bunion?

Raymond Hsu, MD
What is a bunion?

A bunion refers to a bony bump at the base of the big toe. The most common form of bunion, “hallux valgus,” is formed by a change in the alignment of the bones and not from bony growth. A small bump is common and may be part of the normal foot shape. With a bunion deformity, the bones around the great toe have shifted and the metatarsal bone is now pushing out against the skin, creating a more prominent and sometime painful bony bump.

What else could it be?

While bunions are a common foot condition, there are several others that also cause a prominence or swelling around the great toe, such as gout, arthritis, and ganglion cysts. In general, these conditions are differentiated based on your symptoms, an examination, and X-rays.

What causes a bunion?

There are several reasons you might develop a bunion.

  • In general, a bunion develops slowly over years. The bones in the foot shift slowly over time. Certain ligaments stretch out while others tighten. This causes the deformity to occur.
  • Shoes that are tight around the toes such as women’s heels are a risk factor as they push the great toe into the bunion position. This may be one reason that bunions are more common in women. About 10 percent of cases are in men, however, and there is a hereditary component possibly linked to having looser ligaments.
  • Less commonly, children or teenagers may develop bunions from the bones growing primarily into the turned position.
  • Even less commonly, they can occur after a traumatic injury to the ligaments around the great toe.

Is a bunion dangerous and does it get worse?

The most important fact to know is that bunions are not dangerous. Actually, if they do not cause any pain or functional problems, the best advice is to leave them be. Unfortunately, the natural history of a bunion deformity is that it will likely progress with time. The good news is that this generally takes years or decades.

Why does my bunion hurt?

A number of problems can contribute to a painful bunion:

  • arthritis from the joint not being aligned correctly
  • ;the bone pushing on a sensory nerve
  • pain in the ball of the foot as a result of a change in the way the foot moves
  • the great toe rubbing against the smaller toes
  • external pressure from footwear

Those who have a bunion without pain are simply lucky they haven’t developed any of these problems.  If a bunion is not painful, it does not require treatment.

Do bunion splints work?

There is no solid evidence to show that bunion splints or toe spacers can reverse or cure a bunion deformity. Bunion splints and toe spacers, however, are inexpensive and low risk and can provide some symptom relief.

What can I do to treat a bunion?

First, try simple changes such as wider shoes and toe spacers. If that has not helped, then you may want to discuss the option of bunion surgery. Bunion surgery is usually an outpatient surgery that can be done with sedation and local anesthetic.

What is the recovery for bunion surgery?

Recovery involves crutches for a couple of weeks and a medical shoe for at least eight weeks until the swelling is down. Most people can walk on their heel right away but can’t put pressure on the front of their foot for two weeks.

Are there ways to prevent bunions?

While not all bunions can be prevented, there are ways to reduce your risk for developing bunions:

  • Wear comfortable shoes that fit well.
  • Avoid high heels and shoes that push the toes together.
  • See a specialist if you have a severe sprain of the great toe that does not improve in a couple days.
  • Keep track of your feet and monitor any changes over time, especially if foot or ligament conditions are hereditary.

If you have a bunion or other foot condition, we can help. Visit our website for more information.

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