Health Encyclopedia

Bunions

Definition

A bunion is when your big toe points toward the second toe. This causes a bump on the edge of your foot, at the joint of your big toe.

Alternative Names

Hallux valgus

Causes, incidence, and risk factors

Bunions occur more commonly in women and 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 a bunion. The condition may become painful as extra bone and a fluid-filled sac grow at the base of the big toe.

Symptoms

Red, calloused skin along the foot at the base of the big toe
A bony bump at this site
Pain over the joint, aggravated by pressure from shoes
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 and, in some cases, arthritis.

Treatment

When a bunion first begins to develop, take good care of your feet and wear wide-toed shoes. This often solves the problem and prevents the need for any further treatment. It may help to wear felt or foam pads on the foot to protect the bunion, or devices to separate the first and second toes at night. These are available at drugstores. You can also try cutting a hole in a pair of old, comfortable shoes to wear around the house.

If the bunion gets worse -- resulting in severe deformity or pain -- surgery to realign the toe and remove the bony bump (bunionectomy) can be effective. There are over 100 different surgical techniques that have been described to treat this condition.

Expectations (prognosis)

The outlook depends on your age and activities, and the severity of the bunion. Teenagers may have more trouble treating a bunion than adults. Many adults do well by caring for the bunion when it first starts to develop, and wearing different shoes. Surgery reduces the pain in many, but not all, people with bunions.

Complications

Chronic foot pain
Foot deformity
Stiff foot
Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe)

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

Vanore JV. Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 1: Hallux valgus. J Foot Ankle Surg. 2003; 42(3): 112-123.

King DM. Associated deformities and hypermobility in hallux valgus: an investigation with weightbearing radiographs. Foot Ankle Int. 2004; 25(4): 251-255.

Ferrari J, Higgins JP, Prior TD. Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev. 2004.

Review Date:6/18/2008
Reviewed By:A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Andrew L. Chen, MD, MS, Orthopedic Surgery and Sports Medicine, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network (5/5/2008).

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