A bunion is a bony lump or projection that forms at the base of your big toe joint, typically as a result of the upper portion of your toe being pressed inward toward the neighboring toes. As the top of your toe is pushed inward, the joint is gradually displaced, becoming:
Without treatment, the deformity eventually can become permanent, making it very difficult to find shoes that fit comfortably. Continued inflammation in the joint can lead to arthritis and persistent pain, especially when walking and wearing shoes. In people with severe bunions, the big toe joint can become so deformed that the toe itself will be pushed over top of the neighboring toes or it may become twisted.
Bunions often occur in people with specific foot shapes or congenital deformities, or in those who have certain types of gaits. They’re also more common among people with polio and some other diseases, and traumatic injury can also play a role in bunion formation.
Wearing shoes that are very pointy or tight in the toe area can contribute to the development of bunions, especially if you have risk factors for bunions. Likewise, wearing high heels on a regular basis forces your toes down into the restricted toe space, causing your toe joint to move out of position over time.
Your physician will begin your bunion treatment by carefully evaluating your foot and toe joint to confirm the diagnosis of a bunion and examine the extent of the damage and deformity. In some cases, they may order an X-ray to obtain more detailed information that can help guide them in treating your bunion.
When a bunion is relatively mild and the joint is still flexible, stretching exercises and use of special nighttime splints may help by gently coaxing the toe joint back into its proper position. Medications can also help decrease pain and inflammation in the joint and soft padding can reduce friction and soreness in the skin overlying the joint. Many patients find custom orthotics -- special custom-made shoe inserts -- can be very helpful in relieving pressure on the joint and in helping to realign the joint over time.
Switching to shoes that offer more room in the toe is also essential. When these conservative approaches for bunion treatment aren’t effective in providing long-term relief of symptoms, your provider may recommend bunion surgery to realign your big toe joint and hold it in position using tiny screws or pins.
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